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Background: Preoperative anxiety is a common reaction in patients. Many techniques are used for alleviation of it, such as preoperative visit by the anesthetist, reassurance by a psychologist, and prescription of tranquilizer drugs. In this study we surveyed propofol compared to Midazolam on pre-operative anxiolysis. Methods and Materials: In randomized controlled double-blind clinical trial, 60 patient swith ASA class I candidates for elective abdominal operations were randomly allocated in 3 equal groups (propofol, midazolam and normal salin). Anxiety was measured with 2 different scales: visual analogue scale (VSA) and clinical global impression (CGI). Pulse rate (PR), blood pressure (BP), respiratory rate (RR), and saturation PO2 (SPO2) were measured before drug administration and 3 times after that in 2.5 min intervals. Results were analyzed with ANNOVA, repeated measures ANNOVA, TUKEY, and X2 tests. Results: There were no differences in demographic variables between groups. Both propofol and midazolam were more effective than placebo in anxiety reduction. Both drugs had equal effect (p>0.05). There was no significant difference in BP, PR, RR and SPO2 between two drugs. Conclusion: Both drugs were the same and more effective than placebo. Midazolam may be preferred for economical reasons.

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Background: The main advantage of regional anesthesia is the elimination of post-operative pain without the need for narcotics, which leads to a more rapid outpatient recovery and faster return to consciousness in pediatric patients. The aim of this study was to compare caudal anesthesia with midazolam and neostigmin co-administered with bupivacain in reduction of post-operative pain in lower abdominal surgery in pediatrics (2- 8 years old). Materials and Methods: In a double-blind clinical trial, 45 pediatric patients were randomly allocated to midazolam, neostigmine, and placebo groups. Induction of anesthesia was done with inhalation of halothane and O2. Bupivacaine 0.25% in 0.5 ml/kg with midazolam in 50μ/kg was administered in caudal form to the first group, and bupivacaine 0.25% in 0.5 ml/kg with neostigmine in 2 μg/kg dose was administered to the second group. The third group received the placebo plus bupivacaine 0.25% in 0.5 ml/kg. Results: Mean durations of analgesia in neostigmin, midazolam, and placebo groups were 16.5± 0.25, 12.3±0.22, and 6±0.11 hours, respectively (P<0.001). Also, in the neostigmin group, mean score of pain in outpatient recovery 6 , 12 , 24 hours post operatively was less than that in the other two groups (P<0.001). Conclusion: Duration of analgesia period in neostigmin group was more than that in midazolam and placebo groups

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Background: Pain is a complex problem, which can affect patients' physical and psychological condition. Inadequate postoperative pain control has adverse effects on the patients' physiological, metabolic and mental condition. Adding new supplement will increase the duration of analgesia. This study aimed to comparison of intratechal neostigmine and midazolam in increasing the time of postoperative analgesia. Materials and Methods: In this randomized double blind clinical trial, 60 patients with ASA class Ι, II who were candidate for elective colporrhaphy surgery under spinal anesthesia were randomly divided into 3 groups of 20 patients. All patients received hyperbaric lidocaine 5% and groups I received 1 mg midazolam, groups II received 50 μg Neostigmine and groups III received 0.5 cc normal saline additionally. Then according VAS pain score, postoperative painless duration and pain score were compared between groups by running SPSS software. Results: Mean of painless duration in the Midazolam, Neostigmine and control groups were 98.4±18.2, 74.5±32.6 and 64.5±9.9 minutes respectively which was significantly longer than in Midazolam group (p<0.001). The mean dose of requested analgesia in first 24 hours after surgery was significantly lower in Midazolam group (p<0.001). Conclusion: Inthrathecal midazolam and Neostigmine as a complementary medication to lidocaine 5% can increase painless duration in colporrhaphy surgery and midazolam is more effective than Neostigmine. Key Words : midazolam & Neostygmine , Spinal anesthesia, painless time , colporrhaphy

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Background: The aim of this study was to compare the efficacy of ondansetron, Midazolam and metoclopramide with placebo in preventing PONV following strabismus surgery.

Material and Methods: 160 patients were allocated with simple randomization in 4 groups of 40: group ON received Ondansetrone 0.05mg/kg, MT group received Metoclopramide 0.15mg/kg, MD group received Midazolam 0.03mg/kg intravenously and group CT received the solution of NaCl 0.9% as placebo infused with the same volume and the same manner 30 minutes before the end of surgery. The patients were evaluated for nausea, vomiting, need and  dosage of anti-emetic drugs, time of liquid and solid diet tolerance, drug complications and satisfaction score for the initial 24 hours after anesthesia.

Results:  The frequency of nausea (p-value = 0.001< 0.05) and vomiting (p-value=0.084>0.05) was lower in ON group and both of these complications were lower in MD group compared with MT and CT group. Use of rescue antiemetic was higher in MT and CT group (p-value = 0.001 < 0.05). Patient satisfaction was higher in ON group compared with other 3 groups (p-value=0.001<0.05).

Conclusion:   Prophylactic use of Ondansetron is more effective with fewer side effects than Metoclopramide and Midazolam in the prevention of PONV following strabismus surgery. Furthermore, metoclopramide was less effective and was associated with more adverse effects.

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Background:
 
This study aimed to compare the effect of cold eye irrigation solution (BSS) and viscoelastic gel with their combination in room temperature on the dosage of sedative drugs which we use in Phacoemulsification cataract surgery.
 
Material and methods:
 
190 patients scheduled for cataract surgery under sedation were randomly divided into two equal groups. During surgery we used cold (4c) and warm (room temperature) BSS and viscoelastic gel in the first and second group respectively. For all patients we started sedation with Midazolam and Fentanyl and in case we needed additional drug we used Sodium Thiopental till we reached desired sedation level. Ramsay sedation scores (before, during and after surgery) and total sedative drug consumption   were evaluated   and compared between two groups and at the end of the surgery we checked the satisfaction score of patients and surgeon about the quality of sedation.
 
Results:
The average dosage of Midazolam wasn’t significantly different between the two groups, while the average dosage of Sodium Thiopental was significantly lower in Cold group. Also the average time of which we reached desired Ramsay sedation score and the level of Ramsay score were significantly different between the two groups.
 Conclusion:
Using cold BSS and viscoelastic gel in cataract surgery in comparison of their combination in room temperature will reduce the dosage of sedative drugs which we use during surgery and help us getting a more effective sedation and gaining both a satisfied patient and surgeon.