RO 21-3981, a new water soluble benzodiazepine, was studied in 24 patients both as an intravenous premedicant and to induce anesthesia. The premedicant dose of 5 mg produced lack of recall and marked sedation within 1 to 2 minutes after injection and persisted for at least 32 minutes. Subsequent induction of anesthesia required an additional 5 to 25 mg of RO 21-3981. However, anesthesia was not induced in 1 patient with 25 mg and was accomplished only with inhalation anesthesia. Loss of lid reflex was unreliable as a sign of induction for patients in whom tracheal intubation was planned. Although decreases in blood pressure of 10 to 30 mm Hg were noted after administration of RO 21-3981, systolic pressure was not recorded below 90 mm Hg. RO 21-3981, because of its amnesic, sedative, and anxiolytic properties, appears to be an excellent premedicant although the 5 mg dose studied was probably larger than necessary. For induction of anesthesia, RO 21-3981 may be an effective alternative to thiopental.
Fentanyl 0.1 mg and morphine 10 mg alone and in combination with droperidol 2.5 and 5.0 mg were studied for i.v. surgical premedication in 240 patients. Relief of anxiety, sedation, lack of recall, patient acceptance and side-effects were evaluated. The addition of droperidol to fentanyl and morphine produced greater sedation and relief of anxiety before operation, but did not improve patient acceptance or lack of recall.
Diazepam and hydroxyzine as i.v. surgical premedicants were compared. A double-blind randomized sequence was used employing 7.5 and 15 mg of diazepam v. 75 and 150 mg of hydroxyzine. Each group consisted of 35 patients. Anxiety relief, sedation, lack of recall and patient acceptance were the principal assessments. Diazepam was superior to hydroxyzine in all respects. No serious side-effects were noted with either drug.
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