Midazolam versus diazepam as premedication for gynaecologic laparoscopy done under local anaesthesia

Summary

A prospective randomised double blind trial was performed in 106 patients to compare the use of intravenous midazolam (mean dose 6·5 mg. range 4–9 mg) versus 10 mg diazepam. during gynaecologic laparoscopy under local anaesthesia. The parameters examined were: the ease of laparoscopy, patient tolerance, the amnesic effect and intra-operative blood pressure changes. Depth of sedation and recovery time were also measured, using the Trieger test. The preoperative demographic variables and the operators ability to perform the procedures were similar in the two groups. The patients were more deeply sedated with the midazolam but the recovery time was similar. The patients tolerated the procedure better with midazolam with fewer of them describing the procedure as unpleasant (22 per cent versus 53 per cent) (P<0·01), fewer of them had whole hod? movement during the procedure (24·5 versus 54·5 per cent) (P = 0·009) and more of them had amnesia for the procedure (85 per cent versus 36 per cent) (P < 0·4001). Houeber mean blood pressure rose to hypertensive level intra-operatively in the midarolam group but not in the diazepam group.