Adrenergic modulation of preoperative anxiety: a comparison of temazepam, clonidine, and timolol

To assess the influence of adrenergic modulation on preoperative anxiety, we used a randomized, double-blind, placebo-controlled trial to compare temazepam, clonidine, and timolol as preanesthetic medications in patients undergoing minor orthopedic surgery. All the active treatments resulted in less preoperative anxiety than the placebo (control) did. Induction of anesthesia was smoother in all the treated patients compared with the control group. Recovery was slowest in the temazepam and clonidine groups, but there were no significant differences between the groups after 90 min. Cardiovascular changes were most marked in the timolol group. Pain scores were lower in the temazepam and clonidine series in the early postoperative period. Neither clonidine nor timolol offers any major advantage over temazepam for premedication in these patients.