Oral premedication one hour before minor gynaecological surgery--does it have any effect? A comparison between ketobemidone, lorazepam, propranolol and placebo

The purpose of the present study was to compare the effects of oral premedication with ketobemidone 5 mg, lorazepam 1 mg, propranolol 40 mg or placebo, given about an hour prior to anaesthesia, in a prospective randomized double-blind fashion. One hundred and twenty ASA I female patients scheduled for elective laparoscopy were randomly prescribed one of the study drugs. Patient evaluation of anxiety, nurse evaluation of premedication, induction and postoperative course were studied. Ninety-three of the 120 patients (78%) experienced no change or a decrease in anxiety, regardless of type of active drug or placebo administered. Eighty-eight of the patients (73%) were considered adequately premedicated by the nurse observer, with no differences between the groups. Pre induction pulse rate, blood pressure and amount of induction agent needed was also similar between the four groups of patients. No major differences could be seen during the postoperative course. We found no major effects of any of the active drugs studied compared to placebo. Routine use of small doses of oral premedication one hour before elective surgery among low anxiety patients could probably be omitted.