Sublingual lorazepam as premedication in peribulbar anesthesia

Area of Science:

• Ophthalmology
• Anesthesiology
• Pharmacology

Background:

• Peribulbar anesthesia is commonly used for ophthalmic surgeries.
• Patient anxiety and memory of the procedure can impact the overall surgical experience.
• Premedication aims to improve patient comfort and reduce anxiety during surgery.

Purpose of the Study:

• To evaluate the effectiveness of sublingual lorazepam as a premedication for inducing amnesia.
• To assess the impact of sublingual lorazepam on patient sedation, analgesia, and akinesia during peribulbar anesthesia.

Main Methods:

• A prospective, randomized, placebo-controlled, double-blind study was conducted.
• Sixty patients undergoing routine cataract or glaucoma surgery received either 1 mg sublingual lorazepam or a placebo 1 hour preoperatively.
• Patients were assessed for sedation, akinesia, intraoperative analgesia, and amnesia.

Main Results:

• No significant differences were observed in sedation, analgesia, or akinesia between the lorazepam and placebo groups.
• Patient-reported amnesia was significantly higher in the lorazepam group compared to the placebo group (P < .05).
• Overall patient response was improved in the lorazepam group (P = .05).

Conclusions:

• Sublingual lorazepam is effective in inducing amnesia, thereby enhancing patient comfort during peribulbar anesthesia.
• The low dose used did not cause adverse effects such as excessive sedation, making it suitable for routine ophthalmic surgeries.
• Lorazepam premedication offers a safe and effective method to improve the patient experience in cataract and glaucoma surgery.