Co-induction with propofol, remifentanil and midazolam in short-stay surgical procedures [Kisa süreli cerrahi girişimlerde propofol, remifentanil ve midazolam ile ko-indüksiyon]

Aim: The aim of the study was to investigate the effects of midazolam on the anesthesia induction, recovery and cost in outpatients receiving propofol-remifentanil combination. Materials and Methods: Eighty unpremedicated patients undergoing hysteroscopy were randomly allocated in to one of two groups: Group PRM received midazolam 0.04 mg kg-1 iv and remifentanil 1 µg kg-1, and Group PR received salin remifentanil 1 µg kg -1 iv. Then both groups received titrated doses of propofol iv for anesthesia induction until loss of eyelash reflex. Anesthesia was maintained with remifentanil infusion 0.25 µg kg-1dk-1, 50% N 2O in O2 and titrated propofol. The time to loss of verbal contact, eyelash reflex and the time to tolerance of face mask were recorded. Hemodynamics measurements, the times to spontaneous eye opening and obeying verbal comments and Aldrete recovery scores were recorded. In the postoperative period psychometric and psychomotor functions were evaluated with Camron test. The induction dose and total propofol dose recorded. Results: There were no differences in hemodynamics measurements between groups. The loss of verbal contact and eyelash reflex and the time to tolerance of face mask significantly shorter in group PRM at induction. In group PRM the times to spontaneous eye opening and obeying verbal comments were signicantly longer at the end of anesthesia. The times to Aldrete scor >9 were similar in boths groups. The number of patients with Camron score >8 during the 30 min were lower in Group PRM. The propofol doses (induction and total doses) were significantly decreased in Group PRM and the cost of anesthesia were significantly lower in Group PRM. Conclusion: Midazolam-remifentanil-propofol co-induction may be an alternative choice for anesthesia induction because it shortens induction times. Although it prolongs the time to awakness, it dose not affect the recovery times and reduces the anesthetic costs