Summary
A double-blind random study compared the effects of lorazepam and pantopon as intra-muscular premedication in healthy women for uterine curettage ( D & C ). Anxiety, as assessed by a self-rating test by the patient and by a trained observer, showed a significant reduction at one and one-half hours after lorazepam and a smaller reduction after pantopon, which was not significant. Sedation was satis-factory with no significant difference between the two drugs in the change before and after the premedication. Lorazepam showed much more amnesia than pantopon (p < 0.001). The patients who had lorazepam required higher doses of thiopentone for the operation, and this, in part, led to longer intervals in recovery times after lorazepam. However, it is suggested that lorazepam itself was partly responsible for the longer recovery. Pantopon was followed by more nausea, vomiting and headaches, than lorazepam. The intra-muscular injection of lorazepam hurt more patients than did pantopon, but other local complications were negligible and comparable in both groups. The results of this study show that lorazepam produces better reduction of anxiety and much more amnesia than pantopon, with comparable sedation and much less nausea and vomiting. The only disadvantage of lorazepam is the lack of analgesia and, therefore, the need for more anaesthesia during the operation. The conclusion is that lorazepam is a very satisfactory premedication and warrants more use as such.
Résumé
Une étude à double insu, comparant le Lorazepam et le Pantopon comme agents de prémédication par voie IM a été effectuée chez des jeunes femmes en bonne santé, devant subir un curetage.
L’anxiété évaluée par la patiente elle-même ainsi que par nn observateur entraîné était diminuée 1 h. et 1:30 h. aprés radministration du Lorazepam; un effet légèrement inférieur était noté après le Pantopon (différence non significative). L’action sédative était satisfaisante et comparable avec les deux agents.
L’amnésie produite par le Lorazepam a étv plus marquée qu’avec le Pantopon (p 0.001).
Les patientes prémédiquées au Lorazepam ont nécessitié des doses plus fortes de Thiopentone, ce qui allongea la période de recouvrance. Cependant, le Lorazepam semble également contribuer à un éveil plus long.
L’administration de Pantopon a donné lieu à plus de nausées, de vomissements et de céphalées comparativement au Lorazepam. Mais ce dernier a provoqué une douleur plus intense au site d’injection.
Les autres complications locales étaient négligeables dans les deux groupes d’étude.
Les résultats de cette étude, montrent que le Lorazepam est meilleur anxiolytique et occasionne moins de nausées et de vomissements, avec une sédation comparable au Pantopon. Son seul désavantage est qu’il a un faible effet analgésique et nécessite plus d’agents anesthésiques pendant l’intervention.
On peut conclure d’après cette étude que le Lorazepam est un bon agent de prémédication.
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Gale, G., Galloon, S. Lorazepam as a premedication. Canad. Anaesth. Soc. J. 23, 22–29 (1976). https://doi.org/10.1007/BF03004991
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DOI: https://doi.org/10.1007/BF03004991