Anesthesia & Analgesia

Date Published: 
October 2004

Paradoxical Increase in Pain Requirements with Midazolam Premedication

Congratulations to Ma et al. (1) on their recent publication. While the
administration of midazolam is a routine for most anesthesiologists,
its inclusion in the Ma et al. protocol may confuse the issue of the
efficacy of perioperative rofecoxib, inasmuch as Oxorn et al. (2)
reported a statistically significant threefold incidence in midazolam
premedicated patients requesting pain medication in recovery compared
with those who did not receive midazolam. '

Barry L. Friedberg, MD
Volunteer Instructor in Clinical Anesthesia
University of Southern California Los Angeles, CA


1. Ma H, Tang J, White PF, et al. Perioperative rofecoxib improves
early recovery after outpatient herniorrhaphy. Anesth Analg
2. Oxorn DC, Ferris LE, Harrington E, et al. The effects of midazolam
on propofolinduced anesthesia: propofol dose requirements, mood
profiles, and perioperative dreams. Anesth Analg 97;85:5543–9.

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