The Relationship of Intravenous Midazolam and Posttraumatic Stress Disorder Development in Burned Soldiers

Abstract

Background: Midazolam, a short- acting benzodiazepine, is administered preoperatively and intraoperatively for amnesia and anxiolysis. Subsequently, patients often do not recall events which occurred while they were sedated. Recent studies have also reported retrograde facilitation after midazolam exposure. Posttraumatic stress disorder PTSD is based on memory of a traumatic event. Because of the concern that midazolam may enhance memory of the traumatic event in which soldiers were injured, we investigated the prevalence of PTSD in those burned soldiers who received peri-operative midazolam and those who did not. We also investigated the intensity of the memories related to the traumatic event. Methods: After institutional review board approval, all charts of US soldiers who completed the PTSD Checklist-Military (PCL-M) screening tool (2004 2008) after admission to US Army Institute of Surgical Research were reviewed to determine the number of operations, the anesthetic regime, total body surface area (TBSA) burned, and Injury Severity Score (ISS). Results: The PCL-M was completed by 370 burned soldiers from Operation Iraqi Freedom/Operation Enduring Freedom. During surgery, 142 received midazolam, whereas 69 did not. The prevalence of PTSD was higher in soldiers receiving midazolam as compared with those who did not (29% vs. 25%) (p 0.481). Both groups had similar injuries based on TBSA and ISS. Patients who received midazolam also had similar scores on PCL-M questions related to memory of the event. Conclusions: Rates of PTSD are not statistically different in combat casualties receiving midazolam during intraoperative procedures. Intraoperative midazolam is not associated with increased PTSD development or with increased intensity of memory of the traumatic event. Patients receiving midazolam had similar injuries (TBSA and ISS) and underwent a similar number of operations as those not receiving midazolam.

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Document Details

Document Type
Technical Report
Publication Date
Apr 01, 2009
Accession Number
ADA627473

Entities

People

  • Christopher V. Maani
  • Ian H. Black
  • Kathryn M. Gaylord
  • Laura L. Mcghee
  • Peter A. Desocio
  • Thomas H. Garza

Organizations

  • United States Army Institute of Surgical Research

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Afghanistan Conflict
  • Anxiety Disorders
  • Brain
  • Burns
  • Central Nervous System
  • Diseases And Disorders
  • Drug Abuse
  • Iraqi-War
  • Medical Personnel
  • Mental Disorders
  • Military Medicine
  • Nervous System
  • Patient Care
  • Regression Analysis
  • Statistical Analysis
  • Traumatic Stress Disorder
  • United States Government

Fields of Study

  • Medicine

Readers

  • Canadian European Scientific Immigration and Epilepsy Clearance Studies
  • Mental Health of Military Veterans with Posttraumatic Stress Disorder (PTSD): Risk Factors, Prevalence, Symptoms, and Treatment.
  • Trauma Surgery or Emergency Medicine.