ISSN:
1432-055X
Keywords:
Schlüsselwörter Orale Prämedikation
;
Dikaliumclorazepat
;
Midazolam
;
Anxiolyse
;
präoperativer Streß
;
Key words Oral premedication
;
Midazolam
;
Clorazepate dipotassium
;
Anxiolysis
;
Sedation
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Description / Table of Contents:
Abstract Benzodiazepines are the most commonly used anxiolytic agents. Among the benzodiazepines, midazolam has the advantage of a short elimination half-life, which is especially useful in outpatient surgery. However, in contrast to other commonly prescribed benzodiazepines, such as chlorazepate dipotassium, oral premedication with midazolam has not been thoroughly investigated. Therefore, the present study was performed to compare anxiolysis, sedation and stress reduction with midazolam and clorazepate dipotassium in adults. Methods. After IRB approval and informed consent had been obtained, 85 patients scheduled for breast biopsy were studied. The patients were chosen at random to receive either 7.5 mg midazolam (n=29), 20 mg clorazepate dipotassium (n=28) or placebo (n=28) preoperatively. Before premedication, immediately prior to surgery and postoperatively in the recovery room, the following parameters were determined with visual analogue scales (VAS): “asthenia,”“depression,” oral salivation, muscle tension, motoric restlessness and sweating of the palms. In addition, anxiety (STAI-G-X-1, Spielberger), heart rate and arterial blood pressure were measured. Before patients underwent surgery, the degree of sedation was evaluated by the anaesthesiologist. Results. Clorazepate dipotassium and midazolam both caused a reduction in anxiety as compared with the placebo (P〈0.05). Only clorazepate dipotassium reduced anxiety postoperatively (P〈0.05). Neither midazolam nor clorazepate dipotassium caused a reduction in “asthenia” and “depression.” Midazolam was more effective in preventing increased blood pressure than clorazepate dipotassium and the placebo (P〈0.05). Furthermore, after premedication with midazolam, salivation, muscle tension, motoric restlessness and sweating of the palms remained stable, in contrast to the results after premedication using clorazepate dipotassium or placebo (P〈0.05). Conclusions. The anxiolytic effects of 7.5 mg midazolam and 20 mg clorazepate dipotassium were similar after oral application. However, the anxiolytic effect of midazolam is shorter-lived than that of clorazepate dipotassium. In contrast to clorazepate dipotassium, midazolam produced no increase in arterial blood pressure and stabilized oral salivation, production in the palms, muscle tension and motoric restlessness.
Notes:
Zusammenfassung Ziel der Studie war die Beurteilung von Angst, präoperativer Streßreaktion und Sedierung nach oraler Prämedikation mit Midazolam. 85 Patientinnen, die sich einer Probeexzision der Mamma unterzogen, erhielten entsprechend einem randomisierten Doppelblindplan 2 h präoperativ entweder 7,5 mg Midazolam (n=29), 20 mg Dikaliumclorazepat (DKC) (n=28) oder ein Plazebo (n=28). Der anxiolytische Effekt wurde anhand der „situativen Angst“ (STAI-G-X-1, Spielberger), der sedierende Effekt anhand einer rangskalierten Fremdbeurteilung und die Streßreduktion anhand vegetativer Parameter sowie der Ausprägung von „Asthenie“ (müde-frisch) und „Depression“ (gleichgültig-interessiert) beurteilt. Im Vergleich zur Plazebogruppe war die „situative Angst“ unmittelbar präoperativ in der Midazolam- und DKC-Gruppe geringer, postoperativ im Aufwachraum aber nur in der DKC-Gruppe vermindert. „Asthenie“ und „Depression“ waren in den drei Gruppen gleich stark ausgeprägt, während die vegetative Blockade nach Midazolamgabe stärker war als nach DKC- oder Plazeboverabreichung. Eine Sedierung der Patientinnen war in der Midazolam- und DKC-Gruppe gegenüber der Plazebogruppe in gleicher Ausprägung nachweisbar.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001010050283
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