Comparison Of Propofol And Midazolam On Patients Undergoing Spinal Surgery With Intraoperative Wake-Up Test: Randomized Clinical Trial

Abstract

Background and objectives: Instrumentation in correction operations for spinal deformities carries a 0.5-5% risk of injuring the spinal cord. The wake-up test is used for early detection of these injuries. In this study we compared the effects of propofol and midazolam during wake-up test in scoliosis surgery. Methods: Thirty patients were randomly assigned as group P and group M. Anesthesia was induced with propofol 2.5 mg kg(-1) for group P or midazolam 0.5 mg kg-1 for group M with remifentanit 0.5 vig kg(-1) and cisatracurium 0.15 mg kg(-1) for both groups. At the maintenance of anesthesia O-2/air and infusions of remifentanil and cisatracurium were used. In group P, propofol 6-10 mg kg(-1) h(-1) and in group M, midazolam 0.5 mg mg kg(-1) were preferred. Approximately 15 min before the wake-up test, all drugs were discontinued. At the wake-up test, anesthesiologist asked the patients to open their eyes and squeeze his/her hand at every 30s until the patients responded. Then patients were told to wiggle their toes. Hemodynamic parameters, time of eye-opening, appropriate movement upon verbal command were evaluated. BPS frequency throughout the operation was recorded. Results: The eye opening time was 9 + 2.15 min in group P and 7 +/- 3.15 min in group M. Motor movement time was 12 +/- 2.55 min in group P and 21.25 +/- 3.93 min in group M. Conclusion: Propofol provided better wake-up conditions and conducted a better neurologic assessment within the same BIS values than midazolam. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.