Intraoperative bispectral index scores were significantly lower in the MMD group ( P < 0.001 ) than in the midazolam-meperidine group.Lower additional ( P = 0.001 ) and total ( P = 0.003 ) doses of midazolam were required in the MMD group.Patients in the MMD group showed lower pain scores ( P < 0.001 ) and higher satisfaction scores ( P < 0.001 ) .