Perioperative medicine & outcomes
The association between midazolam premedication and postoperative delirium - a retrospective cohort study
Main finding · Postoperative deliriumResult — go to the resultAdjusted odds ratio 1.09 95% CI 0.82–1.45Authors' conclusion
Our results suggest that low doses of midazolam can be safely used to pre-medicate elective surgical patients 70 years or older before non-cardiac surgery, without significant effect on the risk of developing postoperative delirium.
Study context
- Population
- Patients ≥70 years having elective non-cardiac surgery under GA, single tertiary academic centre, 2020–2021analysed
- Participants
- 1,973 patients
- Exposure
- Midazolam premedication vs no midazolam premedication
- Midazolam premedicationn = 782
- Outcome
- Postoperative delirium (composite:
- Positive 4A's test in PACU and/or first 2 postoperative days
- New-onset confusion in records by CHART-DEL
- Positive 3D-CAM)
Methodological detailssingle-centre
- Single-centre
Main finding
Postoperative delirium
Adjusted odds ratio
1.09
95% CI 0.82–1.45
P = 0.538
Midazolam vs No midazolam
aOR 1.09 (95% CI 0.82–1.45); P = 0.538
As reported in the abstract
- Overall incidence of postoperative delirium
- 15.3% (302/1973)
Observational data: associations, not effects.
Further findings
Composite of other postoperative complications
- Midazolam premedication not associated with the composite
Postoperative delirium (sensitivity analyses)
- No association in any sensitivity analysis
Original publication
The association between midazolam premedication and postoperative delirium - a retrospective cohort study. J Clin Anesth. Published 4 June 2023. doi:10.
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