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Midazolam versus hydroxyzine as intramuscular premedicant
Canadian Anaesthetists' Society Journal
|March 1, 1983
Summary
Midazolam, a premedicant drug, demonstrated superior anxiolysis, amnesia, and patient satisfaction compared to hydroxyzine. Hyoscine enhanced sedative effects, but atropine did not.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Preoperative medication is crucial for patient comfort and procedural success.
- Evaluating sedative and amnesic properties of commonly used premedicants is essential.
Purpose of the Study:
- To compare the efficacy and safety of midazolam and hydroxyzine as intramuscular premedicants.
- To assess the influence of atropine and hyoscine on these premedicants.
Main Methods:
- Randomized, double-blind, placebo-controlled trial.
- Intramuscular administration of midazolam (0.08 mg/kg) or hydroxyzine (1.5 mg/kg), with or without atropine (0.4 mg) or hyoscine (0.4 mg).
- Evaluation of onset, anxiolysis, amnesia, local irritation, patient/anesthetist ratings, and systemic toxicity.
Main Results:
- Midazolam exhibited faster onset, superior anxiolysis (first hour), greater amnesia, less local irritation, and higher patient ratings.
- Drowsiness was noted with midazolam but was not severe or prolonged.
- Hyoscine, unlike atropine, potentiated the sedative effects of both drugs.
- No systemic toxicity was observed for either midazolam or hydroxyzine.
Conclusions:
- Midazolam is a promising intramuscular premedicant, particularly when anesthetic induction follows in 30-60 minutes.
- Hyoscine can enhance the sedative and amnesic effects of premedicant drugs.