• Kelika Prakash, Tanvi Meshram, and Priyanka Jain.
• Department of Anaesthesiology and Critical Care, Institute of Liver and Biliary Sciences, New Delhi, India.
• Acta Anaesthesiol Scand. 2021 Aug 1; 65 (7): 870-876.

BackgroundMidazolam reduces post-operative nausea and vomiting (PONV) when compared to a placebo or when used as an adjuvant to other antiemetics. The present study was designed to compare midazolam with a combination of dexamethasone-ondansetron in preventing PONV.MethodsOne hundred and twenty patients undergoing laparoscopic surgeries having 2 or more risk factors for PONV (simplified Apfel score) were randomised into 2 groups of 60 each. Patients in group D received 8-mg dexamethasone and 4-mg ondansetron for PONV prophylaxis while those in group M received 2-mg midazolam towards the end of surgery. The proportion of patients (frequency) who had PONV, post-operative nausea (PON) and post-operative vomiting (POV) was noted over 24 hours over the following intervals: 0-2 hours, 2-24 hours and 0-24 hours.ResultsThe frequency of PONV at 24 hours in group D and group M was 30% and 33.3% respectively and was not significantly different (P = .70). There was no difference in the time to achieve post-anaesthesia discharge score of ≥9 between the two groups {5 minutes (5, 5) in group D; 5 minutes (1.25, 5) in group M, P = .48}. Ten patients in group D and 11 in group M required a rescue antiemetic over 24 hours (P = .81). The frequency of PON, POV and PONV as well as the median PONV score was similar at all time periods.ConclusionMidazolam does not result in significantly different frequency of PONV than a combination of dexamethasone-ondansetron.© 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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