Background: Vasovagal reactions during application of intrathecal anaesthesia (IA) are associated with high anxiety levels. A high percentage of patients undergoing outpatient surgery suffer from anxiety. Anxiolytic premedication in day-surgery is suspected to delay recovery and discharge and is, therefore, not routinely used. The aim of this retrospective analysis was to detect the influence of anxiolytic premedication on the incidence of vasovagal reactions and time until discharge home.
Methods: Anaesthesia records of all patients undergoing outpatient surgery under low-dose IA from January 2008 to June 2017 were analysed. Incidences of vasovagal reactions with a decrease in blood pressure and/or heart rate and need for cardiovascular activating medications were documented. Patients were categorised as having received an anxiolytic premedication or not. The time from intrathecal injection of the local anaesthetic until readiness for discharge was recorded.
Results: The records of 2747 patients were analysed. One thousand two hundred and ninety-one of them received an anxiolytic premedication of 1-2 mg midazolam intravenously. Three hundred and fourteen patients had vasovagal incidents during application of IA (no premedication n = 217 [15.0%], premedication n = 97 [7.5%], P < 0.0001). Premedication did not prolong time to achieve readiness for discharge (mepivacaine: P = 0.5886, chloroprocaine: P = 0.1555). However, in the prilocaine group, premedication led to a significantly earlier achievement of readiness for discharge (P = 0.0002).
Conclusion: Anxiolytic premedication significantly reduces the incidence of vasovagal reactions during the application of IA and does not affect time until readiness for discharge.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/aas.13297 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Treatment outcomes in adult patients experiencing dental anxiety: A comparative retrospective study.
Spec Care Dentist
January 2025
Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
Aims: To assess and compare the effectiveness of pharmacological and cognitive-behavioral modalities-behavioral methods (BM), nitrous oxide inhalation sedation (NOIS), and premedication with Diazepam-for alleviating anxiety during dental treatment, using completed treatment sessions and adverse outcomes as indicators.
Methods And Results: For 239 patients (515 dental records), 18-53 y/o, who underwent dental treatments under anxiety reduction measures, sessions under NOIS were categorized as "nitrous group" (456 sessions) versus premedication with Diazepam or behavioral strategies (control, 59 sessions). Outcomes were completed treatment sessions considering demographic and clinical parameters, and adverse outcomes during and between sessions.
Acceptability of midazolam and melatonin as premedications for anxious children undergoing general anaesthesia: a qualitative interview study with children, caregivers and health professionals participating in the MAGIC trial.
Trials
December 2024
School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
Background: The acceptability of a children's premedication, prior to general anaesthesia (GA), is fundamental to ensuring positive clinical- and patient-reported outcomes. Midazolam, the current standard premedication, is known to have an unfavourable side-effects profile and presents a degree of risk which is accepted due to a need for compliance. Melatonin is a functionally diverse hormone with anxiolytic properties that offer potential benefits over midazolam.
View Article and Find Full Text PDF[Impact of HypnoVR© with local anesthesia on pain and anxiety during oocyte pick-up].
Gynecol Obstet Fertil Senol
November 2024
Service de gynécologie-obstétrique, CHU l'Archet 2, 151, route de Sainte-Antoine-de-Ginestière, 06200 Nice, France. Electronic address:
Objective: Virtual reality with Snow World shows a 45% decrease in painful peaks during the care of burn victims. Hypnosis has anxiolytic effect and modulate the response to pain. HypnoVR© is based on many concepts recognized in medicine accessible without specific training.
View Article and Find Full Text PDFInfluence of gabapentin on the degree of sedation, physiological variables and propofol dosage in cats premedicated with acepromazine and methadone: a randomized, prospective, blinded, clinical study.
Vet Res Commun
December 2024
Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
This study evaluated the influence of gabapentin on sedation, propofol dosage, and physiological variables in cats premedicated with acepromazine and methadone. Thirty-four cats were randomly assigned to receive 100 mg of oral gabapentin (Gabapentin group) or placebo (Control group) 100 min before intramuscular premedication with acepromazine (0.05 mg/kg) plus methadone (0.
View Article and Find Full Text PDFComparing the Sedative Effects of Intranasal Dexmedetomidine, Midazolam, and Ketamine in Outpatient Pediatric Surgeries: A Randomized Clinical Trial.
Iran J Med Sci
July 2024
Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Background: The management of preoperative anxiety in pediatric patients, as well as its implications, has remained challenging for anesthesiologists. In this study, we compared the safety and efficacy of intranasal dexmedetomidine, midazolam, and ketamine as surgical premedication in children.
Methods: This double-blinded randomized clinical trial was conducted at two tertiary hospitals in January 2014, on 90 children aged between 2-7 years old.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!