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Premedication before elective breast surgery, a comparison between ketobemidone and midazolam
J Jakobsson1, L Andersson, A Nilsson
1Department of Anaesthesiology and Intensive Care, Karolinska Institute of Danderyds Hospital, Sweden.
Acta Anaesthesiologica Scandinavica
|August 1, 1991
Summary
Midazolam effectively reduced preoperative anxiety in female patients undergoing breast surgery compared to ketobemidone. This premedication did not negatively impact postoperative nausea, vomiting, or the need for pain relief.
Area of Science:
- Anesthesiology
- Pharmacology
- Surgical Patient Care
Background:
- Preoperative anxiety is a common concern for patients undergoing elective surgery.
- Effective anxiolysis is crucial for patient comfort and surgical outcomes.
- Comparing different premedication agents is essential for optimizing perioperative care.
Purpose of the Study:
- To compare the efficacy of midazolam versus ketobemidone as premedication for elective breast surgery.
- To evaluate the effects of these premedications on preoperative anxiety levels.
- To assess the impact on postoperative emetic sequelae and the requirement for analgesia.
Main Methods:
- A randomized controlled trial involving 100 female patients scheduled for elective breast surgery.
- Patients received either intramuscular midazolam (4-5 mg) or ketobemidone (1-1.5 ml) as premedication.
- Anesthesia involved thiopentone, fentanyl, atracurium, nitrous oxide, oxygen, and isoflurane.
- Anxiety was assessed using the Visual Analog Scale (VAS); observer ratings and emetic sequelae were recorded over 24 hours.
Main Results:
- Midazolam premedication resulted in anxiety reduction in 69% of patients, compared to 50% with ketobemidone.
- Midazolam was significantly more effective in reducing anxiety in patients with higher baseline anxiety (VAS ≥ 2).
- Observer assessments indicated patients receiving midazolam were more relaxed post-premedication.
- No significant differences were observed in the frequency of postoperative vomiting or the time to first analgesic requirement between the groups.
Conclusions:
- Midazolam appears to be a more effective premedication agent than ketobemidone for reducing preoperative anxiety in female patients undergoing breast surgery.
- The enhanced anxiolytic effect of midazolam did not lead to increased postoperative nausea, vomiting, or delayed need for analgesia.
- Midazolam is a suitable choice for preoperative anxiety management in this surgical population.