Lorazepam and morphine for i.v. surgical premedication

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Lorazepam is used for anxiety and sedation.
• Morphine is a potent analgesic.
• Combined use may enhance procedural sedation.

Purpose of the Study:

• To evaluate the efficacy and safety of intravenous lorazepam alone and combined with morphine for procedural sedation.
• To compare different doses of lorazepam (2 mg vs. 4 mg) in combination with morphine (5 mg).

Main Methods:

• Prospective study evaluating intravenous lorazepam (2 mg and 4 mg) alone and with morphine (5 mg).
• Assessment of sedation, anxiety relief, recall, patient and physician acceptance, and side-effects.
• Statistical analysis to determine significant differences between treatment groups.

Main Results:

• Combination therapy with morphine significantly improved sedation and anxiety relief compared to lorazepam alone.
• Increased lorazepam dose from 2 mg to 4 mg significantly enhanced lack of recall, independent of morphine.
• Patient and physician acceptance showed no significant differences across all tested combinations.
• Restlessness was the primary side-effect, occurring more frequently with 4 mg lorazepam (15%) than 2 mg lorazepam (3%).

Conclusions:

• Intravenous lorazepam combined with morphine offers superior sedation and anxiolysis.
• Higher doses of lorazepam are more effective in preventing recall.
• Restlessness is a dose-dependent side-effect of lorazepam, irrespective of morphine co-administration.