A Dose-Ranging Study of Intraarticular Midazolam for Pain Relief After Knee Arthroscopy

Abstract

We conclude that when intraarticular midazolam was compared with placebo there was a reduction in pain after day-case arthroscopic knee surgery; however, this pain relief was of relatively short duration.

The efficacy of adductor canal blockade after minor arthroscopic knee surgery – a randomised controlled trial

“…There were no statistically significant differences between groups for AUC (weighted average level) regarding pain at rest (0-24 h): 10 (1-23) vs. 13 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) Regarding levels of dizziness, sedation and nausea, number of vomits, number of patients vomiting and consumption of ondansetron, there were no significant differences at any time points between groups.…”

“…[14][15][16][17][18] We considered a 50% reduction (20 mm) to be of clinical relevance. With a type I error (α) of 5% and a power (1-β) of 90%, a sample size of 68 patients, 34 in each group, would be required.…”

Local Anesthetic Agents in Arthroscopy

“…This review is supported by a study by the same author group that found only those with intense pain after arthroscopy had any benefit from intra-articular morphine (Rosseland et al, 1999). Other agents have been studied in with some success including midazolam (increased the time to first analgesia after surgery compared to placebo), clonidine (additive effect with bupivacaine compared to bupivacaine alone) and neostigmine (more effective when compared to morphine) (Batra et al, 2008, Tamosiunas et al, 2005, Yang et al, 1998. Unfortunately these agents have been studies in a very limited capacity and a clear conclusion in unable to be drawn as their effectiveness.…”

Quality of lidocaine analgesia with and without midazolam for intravenous regional anesthesia

“…Clinical studies have demonstrated an enhanced analgesic effect from midazolam when administered by the centroneuraxial route in combination with bupivacaine [24][25][26]. Batra et al [8] demonstrated that intra-articular administration of midazolam reduced postoperative pain after day-case arthroscopic knee surgery.…”

“…Midazolam reduces A-delta-and C-fiber-evoked activity [7]. Intra-articular administration of midazolam decreased postoperative pain after arthroscopic knee surgery [8]. Midazolam combined with bupivacaine improved analgesia quality when used in brachial plexus block [9,10].…”