[Midazolam and lorazepam as premedication. A randomized double-blind study]

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Premedication with benzodiazepines like midazolam and lorazepam is common before surgical procedures.
• Optimizing patient recovery and minimizing side effects are key goals in perioperative care.

Purpose of the Study:

• To compare the efficacy of oral midazolam versus lorazepam as premedication.
• To evaluate effects on patient satisfaction, sedation, cognitive function, and amnesia in different anesthesia settings.

Main Methods:

• A double-blind, randomized clinical trial involving 160 patients undergoing minor gynecological surgery (general anesthesia) or hip arthroplasty (spinal anesthesia).
• Patients received either oral midazolam or lorazepam prior to surgery.
• Outcomes assessed included subjective patient evaluation, sedation levels, cognitive recovery (Simple Paper-and-Pencil test, Postbox test), and amnesic effects.

Main Results:

• In general anesthesia, midazolam resulted in reduced postoperative sedation and amnesia, with faster cognitive recovery compared to lorazepam.
• Under spinal anesthesia, midazolam also facilitated a more rapid return of cognitive function.
• Patient subjective evaluations were also considered.

Conclusions:

• Midazolam appears to be a superior choice for oral premedication when rapid patient recovery is a priority.
• The findings suggest tailored premedication strategies based on anesthesia type may enhance postoperative outcomes.