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

C Bredahl1, L Knudsen, P H Stjernholm

  • 1Anaestesiologisk-intensiv afdeling, Aalborg Sygehus.

Ugeskrift for Laeger
|June 27, 1994
PubMed
Summary

Midazolam is a preferred oral premedication for faster recovery after surgery. This study found midazolam led to less sedation and amnesia, with quicker cognitive function return compared to lorazepam.

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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.

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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.