Use of triazolam and alprazolam as premedication for general anesthesia

Abstract

BackgroundTriazolam has similar pharmacological properties as other benzodiazepines and is generally used as a sedative to treat insomnia. Alprazolam represents a possible alternative to midazolam for the premedication of surgical patients. The purpose of this study was to evaluate the anxiolytic, sedative, and amnestic properties of triazolam and alprazolam as pre-anesthetic medications.MethodsSixty adult patients were randomly allocated to receive oral triazolam 0.25 mg or alprazolam 0.5 mg one hour prior to surgery. A structured assessment interview was performed in the operating room (OR), the recovery room, and the ward. The levels of anxiety and sedation were assessed on a 7-point scale (0 = relaxation to 6 = very severe anxiety) and a 5-point scale (0 = alert to 4 = lack of responsiveness), respectively. The psychomotor performance was estimated using a digit symbol substitution test. As a memory test, we asked the patients the day after the surgery if they remembered being moved from the ward to the OR, and what object we had shown them in the OR.ResultsThere were no significant differences between the groups with respect to anxiety and sedation. The postoperative interviews showed that 22.2% of the triazolam-treated patients experienced a loss of memory in the OR, against a 0% memory loss in the alprazolam-treated patients. In comparison with alprazolam 0.5 mg, triazolam 0.25 mg produced a higher incidence of amnesia without causing respiratory depression.ConclusionsOral triazolam 0.25 mg can be an effective preanesthetic medication for psychomotor performance.

Sedation with oral benzodiazepines in dental practice in cardiac patients

“…Flumazenil has a major advantage of benzodiazepines compared to other sedative drugs, with a rapid antagonistic effect on sedatives, easily reversing sedation. 1,2,10,20,25 Cardiovascular reactions are common in surgical situations and may be related to the response to the activation of α and β-adrenergic receptors, resulting in increased cardiac output, increased peripheral vascular resistance and a possible increase in blood pressure and heart rate, varying from individual to individual. This difference reflects the variability in the adrenal sympathetic activation, which leads to the release of epinephrine and norepinephrine during a stressful situation.…”

“…Its main effects are the reduction of anxiety and panic attacks in patients, thus being a possible alternative premedication for surgical patients. 25 Alprazolam is an anxiolytic agent used as pre-medication due to its short half-life, rapid effect and ease of use when compared to other benzodiazepines. 26 Its effect lasts for about 1-2 hours and it has a lower incidence of paradoxical effects or anterograde amnesia, being a good alternative to sedation.…”

“…In 80% of patients, Alprazolam was as effective as Midazolam to reduce anxiety, but their amnesic effects were not. 10 A study by Kim et al 25 is that the delivered cardioversion shocks are usually carried out without anaesthesia or sedation, causing a painful experience for patients. Previous use of Triazolam decreased anxiety, discomfort, pain and caused amnesia in some patients compared to placebo.…”

Synthesis of Novel 4-R-1,2,4-Triazolin-5-Thiones Containing Space-Hindered Fragment of Phenol

“…Они проявляют противогрибковый (флуко-назол, интраконазол, вориконазол) [1], противо-воспалительный [2], седативный (триазолам, алфа-золам) [3], и противомикробный эффекты [4]. Среди меркапто-и тион-замещенных 1,2,4-триазо-лов было зарегистрировано большое число произ-водных, проявляющих антибактериальные [5,6], фунгицидные [7,8], противотуберкулензые [9] и антимикобактериальные [10] свойства, противора-ковую активность [11,12].…”

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“…The study concluded that there were no significant differences between two groups with respect to anxiety and sedation but amnesic property was seen in triazolam treated patients but not by alprazolam treated patients. 15 White PF et al conducted a study in which midazolam (0.5 mg /kg IV) was found to produce a spectrum of central nervous system activity like sedation and amnesia that was similar to diazepam (0.1-0.3 mg/kg IV). However the slope of midazolam dose response curve for sedation appears to be steeper.…”