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Table 16.51 Miscellaneous Outcomes – Midazolam for Acute Management Post ABI

 
Author/Year/ Country/ Study Design/N Methods Outcomes
Ghori et al. (2008) Ireland RCT PEDro=8 N=30 Population: TBI; Midazolam (MDZ, n=15): Age Range: 18-65 yr; Gender: Male=14, Female=1; Mean Time Since Injury=12.86 hr; Median GCS=4.73. Propofol (PROP, n=13): Age Range: 18-65 yr; Gender: Male=13, Female=0; Mean Time Since Injury=9.07 hr; Median GCS=5.07. Intervention: Patients were randomly allocated to receive MDZ (n=15) or PROP (n=13) sedation. Outcomes were assessed at baseline and 3 mo. Outcome Measure: Glasgow Outcome Score (GOS), Mortality, Disability.
  1. There was no significant difference between MDZ and PROP groups in number of patients with good outcomes (53% versus 54%).
  2. Of the patients who had a poor outcome, there was no significant difference in the mortality rate between MDZ and PROP groups (20% versus 38%; p=0.07).
  3. Of the patients who had a poor outcome, there was no significant difference in the severe disability rate between MDZ and PROP groups (20% versus 15%; p=0.8).
Davis et al. (2001) USA Case Series N=184 Population: TBI; Northern Cohort (n=66): Mean Age=32.9 yr; Gender: Male=53, Female=13. Southern Cohort (n=118): Mean Age=31.2 yr; Gender: Male=89, Female=29. Intervention: Patients received 0.1 mg/kg midazolam without a restricted maximal dose (Group 1) or with a maximal dose of 5 mg (Group 2). Outcome Measure: Systolic Blood Pressure (SBP), Hypotension, Dose.
  1. Patients in the Group 1 received significantly higher doses than those in Group 2 (0.106 mg/kg versus 0.059mg/kg, p<0.0001).
  2. A significant relationship was found between dose and hypotension following intubation (p=0.032) as well as decrease in SBP (p=0.022).
PEDro=Physiotherapy Evidence Database rating scale score (Moseley et al., 2002).