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Updated: Jul 14, 2026
07:02
A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development
Published on: February 11, 2019
[Comparison of premedication regimes. A randomized, controlled trial]
1Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Schwanenweg 21, 24105 Kiel. meybohm@anaesthesie.uni-kiel.de
Der Anaesthesist
|June 7, 2007
Summary
A single evening dose of chlorazepate dipotassium (CD) effectively reduced preoperative anxiety and sympatho-adrenal activity. Additional morning doses of CD or midazolam did not offer further benefits for these anxiety-related measures.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Preoperative anxiety and sympatho-adrenal activity can negatively impact patient outcomes.
- Benzodiazepines are commonly used for premedication to manage anxiety.
- The optimal timing and dosage of benzodiazepines for premedication require further investigation.
Purpose of the Study:
- To evaluate the effects of two different benzodiazepine premedication regimens on anxiety, hemodynamic parameters, sympatho-adrenal activity, and bispectral index (BIS).
- To compare the efficacy of chlorazepate dipotassium (CD) and midazolam in managing preoperative anxiety and physiological stress responses.
Main Methods:
- A prospective, double-blind study involving 50 patients (ASA class I and II).
- Patients were randomized into two groups: Group I received evening and morning doses of CD, while Group II received evening CD and on-demand midazolam.
- Anxiety, hemodynamic data, sympatho-adrenal activity, and BIS were monitored preoperatively.
Main Results:
- The evening dose of 50 mg chlorazepate dipotassium (CD) in both groups prevented an increase in anxiety and sympatho-adrenal activity.
- A morning dose of 25 mg CD in Group I led to a significant decrease in BIS compared to baseline.
- No significant differences were observed between the groups regarding other measured variables.
Conclusions:
- A single 50 mg evening dose of chlorazepate dipotassium appears sufficient for premedication, effectively managing anxiety and sympatho-adrenal activity.
- Administering additional chlorazepate dipotassium or midazolam closer to anesthesia induction did not provide further preoperative benefits for the studied parameters.
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