Premedication for day case surgery

Raybould, D.; Bradshaw, Elizabeth G.

doi:10.1111/j.1365-2044.1987.tb03081.x

Cited by 50 publications

(19 citation statements)

References 10 publications

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“…This finding is supported by previous placebo-controlled studies using several doses of midazolam [21], triazolam and diazepam [22], in which only the largest doses produced measurable anxiolysis, while psychomotor impairment was evident at lower doses [22]. One might question whether the specific anxiolytic effect attributed to BZDs in their role as anaesthetic premedication is not merely a result of generalised CNS depression.…”

Section: ó 2002 Blackwell Science Ltdsupporting

confidence: 58%

Effect of pre‐operative anxiolysis on postoperative pain response in patients undergoing total abdominal hysterectomy

Caumo¹,

Hidalgo²,

Schmidt

et al. 2002

Anaesthesia

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SummaryIn a double blind, placebo-controlled trial, we have assessed the effects of pre-operative anxiolysis on postoperative pain scores in 112 ASA I-II women, aged 18-65 years, scheduled to undergo total abdominal hysterectomy. Subjects were randomly allocated to receive either oral diazepam 10 mg (n ¼ 56) or placebo (n ¼ 56) pre-operatively. Postoperative anxiety, pain scores, analgesic consumption, and sedation were evaluated at several time points during the first 24 h following surgery. Postoperative pain scores were found to be significantly higher in the diazepam group. Trait and state anxiety showed a significant effect on pain scores, independent of the treatment group. No difference was found between the groups in morphine consumption, but there was a significant reduction in morphine consumption with time. The association between anxiety and postoperative pain is well known [1][2][3], and despite the routine use of benzodiazepines (BZD), there is little clinical evidence available on the effects of premedication on postoperative outcomes such as pain scores and analgesic consumption. The effect of premedication has been mainly assessed in relation to: heart rate; blood pressure; neuroendocrine changes; quality of induction of anaesthesia; amnesia and anxiety [4]. It is important that we are aware of the impact that pre-operative anxiety may have on postoperative outcomes [5].The relationship between pre-operative anxiety and postoperative pain is of particular importance, since several pharmacological and non-pharmacological options are available to treat pre-operative anxiety [6]. If increased pre-operative anxiety is associated with increased postoperative pain, then reducing pre-operative anxiety, could reduce postoperative pain.Therefore, the purpose of this study was to assess the effect of pre-operative anxiolysis on postoperative pain scores based on analgesic consumption and pain scores in patients undergoing total abdominal hysterectomy. Methods

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Section: ó 2002 Blackwell Science Ltdsupporting

confidence: 58%

Effect of pre‐operative anxiolysis on postoperative pain response in patients undergoing total abdominal hysterectomy

Caumo¹,

Hidalgo²,

Schmidt

et al. 2002

Anaesthesia

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“…However, other workers have found that either placebo produced comparable effects to 0.3mg.kg-' (15) or 0.6mg.kg-' (16) of midazolam, or that after 0.75 mg.kgp' recovery from anaesthesia was impaired (17). In adults oral premedication with 15 mg of midazolam may delay recovery and discharge from hospital (18). A 0.75 mg.kg-' dose of midazolam was chosen for this study as it had been previously shown to be an effective preanaesthetic medication without causing excessive postoperative sedation (13).…”

Section: Discussionmentioning

confidence: 99%

Oral midazolam premedication for paediatric day case patients

Cray

Dixon

Heard

et al. 1996

Pediatric Anesthesia

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Forty-nine children having day-stay surgical procedures were randomly assigned to receive oral midazolam 0.75 mg.kg-1 or placebo in a double blind fashion. The child's level of anxiety was assessed before premedication using parental, child and observer scales. The child and observer anxiety scores were repeated in the anaesthetic room. Most children presented for anaesthesia in a calm state, irrespective of whether they had received midazolam. Parents tended to overestimate their child's level of anxiety. Observer anxiety scores reliably predicted behaviour during induction of anaesthesia in the absence of a sedative. Observer scores decreased in the midazolam group (P < 0.02), but not in the placebo group, children below six years having the greatest decrease with midazolam. The median time to discharge from hospital was delayed by 30 min in the midazolam group (P < 0.01). Children do not require routine sedative premedication for day case procedures, but oral midazolam is useful in producing calm behaviour in those children with high observer anxiety scores.

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“…Midazolam has been used for sedation by intramuscular (IM),[567] rectal,[8910] oral[111] and sublingual routes,[1213] but each has its own advantages and disadvantages. IM administration, although effective, is not well accepted by children because children have a natural fear for syringes and needles, and also causes distressing pain to children.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of intranasal Midazolam spray as a sedative in pediatric patients for radiological imaging procedures

et al. 2013

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Context:Preoperative anxiety and uncooperativeness experienced by pediatric patients are commonly associated with postoperative behavioral problems.Aims:We aimed to evaluate the efficacy and safety of intranasal Midazolam as a sedative in a pediatric age group for radiological imaging procedures and to note onset of sedation, level of sedation, condition of patient during separation from parents and effect on the cardio-respiratory system.Settings and Design:Randomized double-blinded study.Subjects and Methods:Fifty patients of the pediatric age group of American Society of Anesthesiologist grade 2 and 3 who came for any radiological imaging procedures were studied. Patients were randomly allocated to receive, intranasally, either Midazolam 0.5 mg/kg (group A N = 25) or normal saline (group B N = 25) in both nostrils (0.25 mg/kg in each) 15 min before the procedure. Time for onset of sedation and satisfactory sedation, sedation score, separation score, hemodynamic changes and side-effects were recorded.Statistical Analysis Used:Student's t-test.Results:Intranasal Midazolam group had a significantly shorter time for onset of sedation and satisfactory sedation. Mean sedation score and mean separation score at 10 min and 15 min intervals were significant in intranasal Midazolam as compared with normal saline (P < 0.001).Conclusions:Intranasal Midazolam 0.5 mg/kg is safe and effective and provides adequate sedation for easy separation from the parents and reduced requirement of intravenous supplementation during radiological imaging procedures without any untoward side-effects.

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Premedication for day case surgery

Abstract: Summary

Cited by 50 publications

References 10 publications

Effect of pre‐operative anxiolysis on postoperative pain response in patients undergoing total abdominal hysterectomy

Effect of pre‐operative anxiolysis on postoperative pain response in patients undergoing total abdominal hysterectomy

Oral midazolam premedication for paediatric day case patients

Evaluation of intranasal Midazolam spray as a sedative in pediatric patients for radiological imaging procedures

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