Premedicatie bij (KNO-) operaties onder plaatselijke verdoving

Midazolam 15 mg orally, was compared with the combination of pentobarbital, promethazine, opial and scopolamine as premedication for ear surgery under local anaesthesia in the first of a series of three double blind clinical trials. Sedation, pain sensation and appreciation by patient and surgeon alike were in favour of the pentobarbital regime. Anxiolysis was the same for both regimes. The number of actions needed to administer the medication was basically lower for midazolam. Comparing in a similar, second study midazolam 15 mg with higher doses of 20 mg and 25 mg, the results were satisfactory with the highest dose. Pain during the administration of the local anaesthesia was felt in 16% of the patients. Adding 10 mg morphine intramuscularly in a third study did not prove to diminish the percentage of patients with pain complaints. It is concluded that 25 mg midazolam taken orally 45 minutes pre-operatively is a satisfactory premedication for ear surgery and less troublesome than the pentobarbital, promethazine, opial, scopolamine we used before. In day-care surgery this short acting premedication in our opinion is quite useful