Midazolam has been reported to decrease postoperative nausea and vomiting (PONV). We studied the antiemetic effect of midazolam after middle ear surgery.

In this prospective, randomized, double-blind, placebo-controlled study, 90 healthy patients were scheduled for middle ear surgery (tympanomastoidectomy and tympanoplasty). Patients were randomly divided into two groups; Midazolam 0.075 mg/kg (n = 45) or normal saline (n = 45) was administered after induction of anesthesia. The incidence of PONV, metoclopramide and ketorolac usage, pain, sedation, and other side effects were assessed at 6, 24 h after the operation.

The incidences of PONV were 15 (33%) in midazolam group and 27 (60%) in placebo group during 24 h postoperatively. The incidence of PONV in midazolam group was significantly lower than that in placebo group (P < 0.05). There were no significant differences between groups in adverse events.

Midazolam 0.075 mg/kg was effective for preventing PONV after middle ear surgery without significant adverse effects.