[Evaluation of preoperative anxiety in patients with and without premedication]

The purpose of this investigation was to determine whether elimination of premedication before general anesthesia affects preoperative anxiety.

Subjects were assigned to one of two groups: a sedative group (0.5 mg midazolam i.m., n = 111) or a no-premedication group (n = 98). We used patients' responses to a questionnaire to compare the no-premedication group and the sedative group.

Eighty-three percent of patients in the no-premedication group entered the operating room ambulatory. The responses concerning preoperative anxiety were not different between the two groups. There was a high rate of recall of the conversation before anesthesia induction in the no-premedication group, and most of these patients replied that making conversation before general anesthesia was beneficial to them. Increases in heart rate and blood pressure at the point of entrance to operating room were observed in the no-premedication group, but the degrees of increase were not considered clinically important.

We conclude that elimination of premedication does not increase anxiety in comparison with patients receiving sedatives, but makes patients feel comfortable by way of preoperative conversation. Elimination of premedication also makes ambulatory entrance possible, both improving safety with respect to patient identification and reducing the demand on nursing.