• Muhammad Shahzad Shamim, Syed Ather Enam, Muhammad Zubair Tahir, and Mueenullah Khan.
• Section of Neurosurgery, Department of Anesthesia and Pain Management, Aga Khan University Hospital, Karachi.
• J Pak Med Assoc. 2012 Jun 1;62(6):561-5.

ObjectiveTo evaluate midazolam as an epidural analgesic in patients undergoing single-level microdiscectomy.MethodsThis prospective case control study was carried out at the Aga Khan University Hospital, Karachi, from January 20 to September 20, 2007, on patients undergoing microdiscectomy. Cases (group A) received midazolam with saline, while controls (group B) received saline only, placed intra-operatively over involved nerve root. Post-operatively, patients were monitored for various variables. Data was analysed using SPSS 13.0 and groups were compared using student's t-test for continuous variables and chi square for categorical variables. P-value <0.05 was considered significant.ResultsPatients in group A ambulated earlier (p = 0.005) and although they did not show significantly better post-operative pain control, but post-operative nausea and vomiting (PONV) score was better at six hours (p = 0.020). There was no difference in other variables such as requirement of analgesics, anti-emetics, hospital stay and complications.ConclusionMidazolam may improve post-operative nausea and vomiting score, and may lead to earlier ambulation, without affecting patient's vitals, consciousness, lower extremity power or sensations, and is not associated with adverse effects.

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