Effect of Continuous Infusion of Midazolam on Refractory Headache and/or Nausea in Patients with Intracranial Cancer Lesions

Akiko Hagiwara; Aya Makino; Hiroko Harada; Koji Oda; Sigeko Matsuyama; Tomoko Komatsu; Yumi Sato; Shuichi Kamiyama; Erika Okami; Yukiko Goda

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Effect of Continuous Infusion of Midazolam on Refractory Headache and/or Nausea in Patients with Intracranial Cancer Lesions

VernacularTitle:頭蓋内がん病変による難治性の頭痛および/または悪心に対するミダゾラム持続投与の有用性
Author: Akiko HAGIWARA ¹ ; Aya MAKINO ¹ ; Hiroko HARADA ¹ ; Koji ODA ² ; Sigeko MATSUYAMA ³ ; Tomoko KOMATSU ³ ; Yumi SATO ³ ; Shuichi KAMIYAMA ⁴ ; Erika OKAMI ⁴ ; Yukiko GODA ¹
Author Information

1. Department of Palliative Care, Sapporo City General Hospital
2. Department of Palliative Care, Kushiro Rosai Hospital
3. Department of Nursing, Sapporo City General Hospital
4. Department of Pharmacy, Sapporo City General Hospital
Keywords: intracranial carcinomatous disease; headache; midazolam
From:Palliative Care Research 2024;19(1):71-76
CountryJapan
Language:Japanese
Abstract: Objective: To investigate the effectiveness and safety of continuous infusion of midazolam for the treatment of headache and/or nausea/vomiting in patients with brain tumors or cancer-associated meningitis. Methods: Patients who presented with headache and/or nausea/vomiting and underwent continuous infusion of midazolam from April 2005 to March 2021 were retrospectively analyzed. Results: Among 22 patients, 19 presented with headache and 14 with nausea/vomiting. The success rate of continuous infusion of midazolam for headache was 89% and that for nausea/vomiting was 78%. The mean number of vomiting episodes within 24 hours from the start of midazolam administration was 0.14±0.36, which was significantly lower than that from 24 hours before to the start of administration (1.43±1.60, P=0.015). Sedation was observed as an adverse event in five (23%) patients, but no patients developed respiratory depression. Conclusion: When conventional therapies are ineffective for headache and/or nausea/vomiting caused by brain tumors or cancer-associated meningitis, continuous infusion of midazolam may improve symptoms and should be considered as a treatment option.