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The Effectiveness of Midazolam for Preventing Postoperative Nausea and Vomiting: A Systematic Review and Meta-Analysis

Ahn, Eun Jin MD; Kang, Hyun MD, PhD, MPH; Choi, Geun Joo MD; Baek, Chong Wha MD, PhD; Jung, Yong Hun MD, PhD; Woo, Young Choel MD, PhD

doi: 10.1213/ANE.0000000000001062
Ambulatory Anesthesiology and Perioperative Management: Research Report

BACKGROUND: Previous randomized controlled trials regarding the effectiveness of perioperative midazolam in preventing postoperative nausea and vomiting (PONV) have produced conflicting results. Consequently, the present systematic review was performed to assess the effect of perioperative administration of midazolam on PONV.

METHODS: The MEDLINE®, Embase, and Cochrane Central Register of Controlled Trials databases were searched to identify all randomized controlled trials that investigated the effectiveness of midazolam under general anesthesia. The primary end points were defined as postoperative nausea (PON), postoperative vomiting (POV), and PONV.

RESULTS: From 16 studies, 1433 patients were included in the final analysis. Compared with the control group, patients who received midazolam showed a lower overall incidence of PON (risk ratio [RR], 0.51; 95% confidence interval [CI], 0.40–0.65; I 2 = 35%; number needed to treat [NNT] = 6; number of included studies [n] = 11), POV (RR, 0.46; 95% CI, 0.33–0.65; I 2 = 0%; NNT = 8; n = 10), and PONV (RR, 0.45; 95% CI, 0.36–0.57; I 2 = 31%; NNT = 3; n = 7).

CONCLUSIONS: Perioperative administration of midazolam was effective in preventing PON, POV, and PONV.

Published ahead of print October 29, 2015

From the *Department of Anaesthesiology and Pain Medicine, Inje University, Seoul Paik Hospital, Seoul, Korea; and Department of Anaesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

Accepted for publication September 14, 2015.

Published ahead of print October 29, 2015

Funding: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2012R1A1A1003700).

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Hyun Kang, MD, PhD, MPH, Department of Anaesthesiology and Pain Medicine, Chung-Ang University, College of Medicine, 224-1 Heukseok-dong, Dongjak-gu, Seoul 156-755, Korea. Address e-mail to

© 2016 International Anesthesia Research Society