Comparison of propofol and midazolam on patients undergoing spinal surgery with intraoperative wake-up test: randomized clinical trial

Abstract

© 2013 Sociedade Brasileira de Anestesiologia. Justificativa e objetivos: Métodos: Resultados: Conclusão: 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 2.5mgkg-1for group P or midazolam 0.5mgkg-1for group M with remifentanil 0.5μgkg-1and cisatracurium 0.15mgkg-1for both groups. At the maintenance of anesthesia O2/air and infusions of remifentanil and cisatracurium were used. In group P, propofol 6-10mgkg-1h-1and in group M, midazolam 0.5mgmgkg-1were preferred. Approximately 15min 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. BIS 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.