MedPath

Premedication by Midazolam for Emergency Surgery

Phase 4
Completed
Conditions
Anxiety
Interventions
Drug: placebo administration
Registration Number
NCT02213302
Lead Sponsor
University Hospital, Lille
Brief Summary

Preoperative anxiety is a subjective and painful experience and may have adverse psychological consequences and complicate anesthetic management. The aim of the study is to show the effect of premedication by midazolam on preoperative anxiety assessed by a visual analog scale and by measuring salivary cortisol levels. This study was a monocentric, prospective, blind randomized placebo controlled clinical study. Sixty patients, aged 18 to 79 years, to undergo elective surgery under general anesthesia with tracheal intubation must be enrolled and randomized to receive midazolam (0.02mg/kg) or placebo. The primary outcome is the reduction in anxiety assessed by a visual analog scale. The secondary outcomes are the reduction in salivary cortisol levels, the overall level of anxiety and the evaluation of respiratory and hemodynamic adverse effects of midazolam.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
59
Inclusion Criteria
  • major patient undergoing elective surgery under general anesthesia with tracheal intubation
  • Anesthesia state 1 and 2
  • preoperative fasting for 6 hours
  • information and signed consent
  • social security
  • non pregnant women
Exclusion Criteria
  • anesthesia state above 3
  • midazolam sensibility
  • pregnant or breastfeeding women
  • ICU patients
  • no consent
  • pediatric surgery
  • no social security
  • no tracheal intubation
  • required premedication in placebo group or midazolam sensibility in premedication group

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Isotonic serumplacebo administrationplacebo administration
Isotonic serummidazolam intravenous administrationplacebo administration
Midazolamplacebo administrationmidazolam intravenous administration 0.02mg/kg
Midazolammidazolam intravenous administrationmidazolam intravenous administration 0.02mg/kg
Primary Outcome Measures
NameTimeMethod
visual analog scale of anxietybaseline, up to the end of support in recovery room

visual scale rated from 0 to 10 to describe the intensity of anxiety simple and reproducible measurement for a short period

Secondary Outcome Measures
NameTimeMethod
Global anxietybaseline

rated from 4 to 20 for global anxiety and from 2 to 10 for information request anxiety is high above 10 for women and 12 for men

Intraoperative consumption of hypnotics and opioidsat anesthesia induction up to 10 minutes

Cumulative dose of hypnotics and opioids reduced to dose per kilogram

Intubation scoreafter intubation

Rated from 1 bed conditions for intubation to 5 for excellent conditions

Adverse midazolam effectsbaseline up to the end of support in recovery room

assessed by variations of arterial pressure, heart rate, respiratory rate, oxygen saturation and end tidal of carbon dioxide for hemodynamics and respiratory adverse effects assessed by Observer's assessment of alertness/sedation for deep of sedation rated from 1 sleeping patient to 5 for awake patient

Patient's satisfactionat the end of the support in recovery room

rated from 1 for bad management to 5 for excellent management assessed at the output of the recovery room

Comfort inductionat anesthesia induction

rated from 1 for deep discomfort to 5 for good comfort

Output score of recovery room (Aldrete score)at the end of support in recovery room

rated from 0 to 10 essential for the output of recovery room

salivary cortisol levelbaseline and at the entrance in operating room

biologic measurement non-invasive, inexpensive and easy to perform. two determinations before and after premedication (at least 20 minutes)

Trial Locations

Locations (1)

Emergency, University Hopital

🇫🇷

Lille, France

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