[Friday] Classic high-scoring literature reading · Preoperative midazolam use is not associated with early postoperative delirium

"Literature Intensive Reading" to master the latest academic trends and expand anesthesia expertise to write scientific articles Welcome to Luffy Anesthesia Channel Midazolam Premedication Immediately Before Surgery Is Not Associated With Early Postoperative Delirium Short-term use of midazolam before surgery is not associated with early postoperative delirium 01 Background BACKGROUND : Postoperative delirium is common among older surgical patients and may be associated with anesthetic management during the perioperative period.
The aim of this study is to assess whether intravenous midazolam, a short-acting benzodiazepine used frequently as premedication, increased the incidence of delirium.
Postoperative delirium is common in elderly surgical patients and may be related to perioperative anesthesia management
.

The aim of this study was to assess whether intravenous midazolam, a short-acting benzodiazepine often prescribed as premedication, increases the incidence of postoperative delirium
.

02METHODS: Analyses of existing data were conducted using a database created from 3 prospective studies in patients aged 65 years or older who underwent elective major noncardiac surgery.
Postoperative delirium occurring on the first postoperative day was measured using the confusion assessment method.
We assessed the association between the use or nonuse of premedication with midazolam and postoperative delirium using a χ2 test, using propensity scores to match up with 3 midazolam for each control patient who did not receive midazolam.
For the data to be analyzed, the patients studied were aged 65 years or older and had undergone elective major non-cardiac surgery
.

Delirium on the first postoperative day was measured using the Confusion Assessment
.

We assessed the association between preoperative use or nonuse of midazolam and postoperative delirium using the χ test, using propensity scores to separate midazolam-naïve patients and three midazolam-users in each control group.
patients for comparison
.

Table&Figure Patient Characteristics Propensity Score Match 03 Results RESULTS: A total of 1266 patients were included in this study.
Intravenous midazolam was administered as premedication in 909 patients (72%), and 357 patients did not receive midazolam.
Those who did and did not receive midazolam significantly differed in age, Charlson comorbidity scores, preoperative cognitive status, preoperative use of benzodiazepines, type of surgery, and year of surgery.
Propensity score matching for these variables and American Society of Anesthesiology physical status scores resulted in propensity score–matched samples with 1–3 patients who used midazolam (N = 749) for each patient who did not receive midazolam (N = 357).
After propensity score matching, all standardized differences in preoperative patient characteristics ranged from –0.
07 to 0.
06,indicating good balance on baseline variables between the 2 exposure groups.
No association was found between premedication with midazolam and incident delirium on the morning of the first postoperative day in the matched dataset, with odds ratio (95% confidence interval) of 0.
91 (0.
65- 1.
29), P = .
67.
A total of 1266 patients were included in this study
.

Of these, 909 (72%) patients received intravenous midazolam preoperatively, and 357 patients did not receive midazolam
.

Patients who received and did not receive midazolam differed significantly in age, Charlson disease score, preoperative cognitive status, preoperative benzodiazepine use, type of surgery, and year of surgery, so propensity score matching was used
.

In the propensity score-matched sample, for every 1 patient not using midazolam (N = 357), 1-3 patients using midazolam (N = 749) were matched
.

After propensity score matching, all standard deviations of preoperative patient characteristics ranged from -0.
07 to 0.
06, indicating a good balance of baseline variables between the two exposed groups
.

Matched datasets showed no association between preoperative midazolam administration and the occurrence of delirium on the first morning after surgery (odds ratio 0.
91; 95% CI: 0.
65-1.
2; P=0.
67) 04 CONCLUSIONS: Premedication using midazolam was not associated with higher incidence of delirium on the first postoperative day in older patients undergoing major noncardiac surgery.
rate increase is irrelevant
.

05Article source "ANESTHESIA & ANALGESIA" Category: Home > SCI Journals > International Journal of Medicine: 0003-2999 2020 Impact Factor/JCR Division: 4.
305/Q2 Publishing Country or Region: UNITED STATES Publishing Cycle: Monthly Publishing Year: 1957 Number of articles: 425 Click this cup of learning milk tea.
The learning notes in this issue are as follows.
Click to drink milk teaClick the milk tea to change color, and then slide the pictureMove out the animation + click to penetrate the study notes Design ideas: Professional English: insomnia, insomnia, susceptible population, susceptible population non-cardiac surgery a short-acting benzodiazepine short-acting benzodiazepine premedication premedication anxiolytic anxiolytic nitrous oxide nitrous oxide prospective cohort prospective cohort perioperative administration perioperative administration placebo placebo medical history of coexisting diseases History of comorbidities screening test screening test chronically preoperative use of benzodiazepines long-term preoperative use of benzodiazepines covariate covariates Propensity Score Matching propensity score matching noncranial non-cranial surgery Click the blue word to follow us