Premedication with sublingual triazolam compared with oral diazepam

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Triazolam is a benzodiazepine used for sedation and anxiety relief.
• Sublingual administration offers a potentially faster onset and improved bioavailability.
• Ophthalmic surgery under local anesthesia requires effective patient sedation and anxiolysis.

Purpose of the Study:

• To compare the clinical effects of sublingual triazolam (0.2 mg) with oral diazepam (10 mg) in patients undergoing ophthalmic surgery.
• To evaluate sedative and anxiolytic effects, patient comfort, and side effects.

Main Methods:

• Double-blind study involving 100 ASA I-II patients.
• Comparison of triazolam 0.2 mg sublingual vs. diazepam 10 mg oral.
• Assessment of sedation and anxiety using visual analogue scales by patients and observers at 15-minute intervals.

Main Results:

• Similar onset of sedative and anxiolytic effects for both drugs.
• Triazolam 0.2 mg resulted in significantly deeper sedation than diazepam 10 mg (observer and patient assessments).
• 20% of patients on triazolam experienced excessive sedation, particularly those aged 61-70; no severe cardiorespiratory side effects were noted.

Conclusions:

• Sublingual triazolam 0.2 mg induces deeper sedation compared to oral diazepam 10 mg.
• The 0.2 mg sublingual triazolam dose may be excessive for elderly patients undergoing intraocular surgery.
• Both medications provided comparable anxiety reduction and patient comfort, with limited amnesia.