[Preoperative subjective anxiety. Double blind study using oxazepam]

Amnesia for unpleasant experiences in the immediate preoperative period, reduction of anxiety, and sedation are the major goals of premedication. The purpose of this randomized double-blind study was to evaluate the anxiolytic effects of the benzodiazepine oxazepam. Following approval by the ethics commission and informed consent, 60 ASA class I and II female patients undergoing surgical treatment of radiologically evaluated breast lesions were studied prospectively using the Mannheim protocol for subjective feeling (MESB) and the State-Trait Anxiety Inventory (STAI) to evaluate intensity levels of preoperative anxiety. During a preoperative visit patients were informed about the management of the study: they were asked to report their subjective feelings preoperatively and immediately before induction. Either oxazepam 30 mg or placebo was administered orally in a double-blind manner 90 min before induction. Preoperative anxiety levels were high in both groups. Following administration of the drug, anxiety-intensity decreased significantly on the MESB and STAI. Oxazepam is a useful oral premedicant for providing effective anxiolysis in the immediate perioperative period compared to placebo. The Mannheim protocol for subjective feeling seems to be a better scoring system for evaluating perioperative anxiety as compared to the STAI. It consists of criteria with which the patients can identify themselves during the perioperative phase.