Sublingual Lorazepam: A Better Premedication?

Abstract

The efficacy of a sublingual preparation of lorazepam was compared with an i.m. injection of lorazepam as premedication for 150 patients undergoing minor gynaecological surgery. Anxiety, arousability and recall of auditory, visual and tactile stimuli were used as measurements of the degree and rate of onset of the effects. Anxiety scores decreased in both groups after medication. Patients who received the drug sublingually showed less recall, an earlier onset of sedation, more drowsiness and a longer recovery time than those who received the drug i.m. It is concluded that lorazepam given by the sublingual route is superior to that given i.m. because of more rapid absorption resulting in earlier drowsiness and more amnesia. An additional advantage is the absence of the discomfort of an injection.

Benzodiazepine premedication in general anaesthesia: a clinical comparative study

“…Respiratory depression was observed in 3 patients (1 midazolam, 2 diazepam) in a study of 85 patients by Magni et al 14 In another study prolonged sedation was observed in the sublingual group compared to intramuscular group of lorazepam. 15 Midazolam was found to be preferable to diazepam and lorazepam because shorter duration of action provided lesser chances of delayed recovery or prolonged sedation.…”

Anesthesia for Liposuction and Abdominoplasty

“…or s.l., 1 -2 h preoperatively) is also an effective choice for sedation or anxiolysis. However, the prolonged duration of action may prolong recovery time after shorter cases [261]. Midazolam (5 -7.5 mg i.m., 30 min preoperatively, or 2 mg i.v.…”