Does Midazolam Affect Postoperative Pain?

NCT ID: NCT03499730

Last Updated: 2021-05-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-09-12

Study Completion Date

2021-03-05

Brief Summary

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To investigate whether midazolam has any effect on postoperative pain in outpatient surgery, the investigators will assess the impact of different midazolam doses on pain scores 24h, 7 days and 3 months after open inguinal hernia repair.

The investigators hypothesize that patients being administered higher midazolam doses will refer more pain.

Detailed Description

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Systemic midazolam prescribed perioperatively might have impact on pain, with studies suggesting antinociceptive and hyperalgesic effects. Anxiety might be a confounder in this association. In order to investigate the effect of midazolam on postoperative pain, a prospective cohort study will be conducted in four Portuguese ambulatory surgery units. A convenience sample with consecutive design will include patients admitted for open inguinal hernia repair. After anxiety and pain evaluation, a tailored dose of midazolam will be administered as premedication according to the anesthetist's best judgement within each unit's protocol (routine care; this dose may be null). Subsequent anesthesia and analgesia will be standardized. Postoperative pain will be blindly assessed by telephone interviews at 24h, 7 days, and 3 months. Statistical analysis will be performed separately for each gender, centre and type of anesthesia, adjusting for preoperative anxiety and other confounding variables with multivariate analysis.

The investigators intend to clarify the relation between anxiety, preoperative midazolam and postoperative pain.

Conditions

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Pain, Postoperative

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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Midazolam injection

The dose of preoperative midazolam is the predictor variable and will be registered as a continuous variable in a single cohort.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

\- adults proposed for open inguinal hernia repair in Portuguese ambulatory surgery units

Exclusion Criteria

* psychiatric disorders
* alcoholism
* illiteracy or poor understanding of the Portuguese language
* history of chronic pain under opioids
* recurrent surgery
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universidade do Porto

OTHER

Sponsor Role lead

Responsible Party

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Caroline Dahlem

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Caroline Dahlem, MD

Role: PRINCIPAL_INVESTIGATOR

UPorto /CINTESIS

Locations

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Centro Hospitalar Baixo Vouga, EPE

Aveiro, , Portugal

Site Status

Centro Hospitalar Universitário do Algarve

Faro, , Portugal

Site Status

Centro Hospitalar Entre Douro e Vouga, EPE

Santa Maria da Feira, , Portugal

Site Status

Centro Hospitalar Vila Nova de Gaia / Espinho, EPE

Vila Nova de Gaia, , Portugal

Site Status

Countries

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Portugal

References

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Mantegazza P, Parenti M, Tammiso R, Vita P, Zambotti F, Zonta N. Modification of the antinociceptive effect of morphine by centrally administered diazepam and midazolam. Br J Pharmacol. 1982 Apr;75(4):569-72. doi: 10.1111/j.1476-5381.1982.tb09175.x.

Reference Type BACKGROUND
PMID: 6121598 (View on PubMed)

Okulicz-Kozaryn I, Kaminska E, Luczak J, Szczawinska K, Kotlinska-Lemieszek A, Baczyk E, Mikolajczak P. The effects of midazolam and morphine on analgesic and sedative activity of ketamine in rats. J Basic Clin Physiol Pharmacol. 2000;11(2):109-25. doi: 10.1515/jbcpp.2000.11.2.109.

Reference Type BACKGROUND
PMID: 11037766 (View on PubMed)

Tatsuo MA, Salgado JV, Yokoro CM, Duarte ID, Francischi JN. Midazolam-induced hyperalgesia in rats: modulation via GABA(A) receptors at supraspinal level. Eur J Pharmacol. 1999 Apr 1;370(1):9-15. doi: 10.1016/s0014-2999(99)00096-5.

Reference Type BACKGROUND
PMID: 10323274 (View on PubMed)

Frolich MA, Zhang K, Ness TJ. Effect of sedation on pain perception. Anesthesiology. 2013 Mar;118(3):611-21. doi: 10.1097/ALN.0b013e318281592d.

Reference Type BACKGROUND
PMID: 23314164 (View on PubMed)

Kain ZN, Sevarino F, Pincus S, Alexander GM, Wang SM, Ayoub C, Kosarussavadi B. Attenuation of the preoperative stress response with midazolam: effects on postoperative outcomes. Anesthesiology. 2000 Jul;93(1):141-7. doi: 10.1097/00000542-200007000-00024.

Reference Type BACKGROUND
PMID: 10861157 (View on PubMed)

Coulthard P, Rood JP. An investigation of the effect of midazolam on the pain experience. Br J Oral Maxillofac Surg. 1992 Aug;30(4):248-51. doi: 10.1016/0266-4356(92)90268-n.

Reference Type BACKGROUND
PMID: 1510899 (View on PubMed)

Day MA, Rich MA, Thorn BE, Berbaum ML, Mangieri EA. A placebo-controlled trial of midazolam as an adjunct to morphine patient-controlled analgesia after spinal surgery. J Clin Anesth. 2014 Jun;26(4):300-8. doi: 10.1016/j.jclinane.2013.12.011. Epub 2014 Jun 2.

Reference Type BACKGROUND
PMID: 24882605 (View on PubMed)

Hasani A, Maloku H, Sallahu F, Gashi V, Ozgen SU. Preemptive analgesia with midazolam and diclofenac for hernia repair pain. Hernia. 2011 Jun;15(3):267-72. doi: 10.1007/s10029-010-0772-y. Epub 2010 Dec 28.

Reference Type BACKGROUND
PMID: 21188440 (View on PubMed)

Ong CK, Seymour RA, Tan JM. Sedation with midazolam leads to reduced pain after dental surgery. Anesth Analg. 2004 May;98(5):1289-93, table of contents. doi: 10.1213/01.ane.0000111107.18755.cc.

Reference Type BACKGROUND
PMID: 15105203 (View on PubMed)

Other Identifiers

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Midazolam OBS

Identifier Type: -

Identifier Source: org_study_id

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