Anesthesia & Analgesia

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