Tolksdorf W, Siefert S, Schmitt W
Klinik für Anästhesiologie, Medizinische Fakultät der RWTH Aachen.
Anaesthesist. 1990 Jan;39(1):1-5.
Despite the fact that dipotassium chlorazepate (DC) is widely used for oral premedication there are few studies demonstrating the effects of this drug reliably in the preoperative patient. Therefore, we investigated the influence of DC on preoperative sleep, stress and postoperative pain, which is presumed to be influenced by the long-acting anxiolytic property of DC compared to a placebo in a double-blind study. Sixty patients undergoing dental surgery received either 20 mg DC or a placebo in the evening and at 7 o'clock in the morning before the operation, both administered orally. The quality of sleep, preoperative anxiety, depression, asthenia and postoperative pain were assessed, using nominal and visual analogous scales. The degree of sedation and the quality of premedication were assessed by the anesthesiologist. Blood pressure and heart rate were registered and interpreted as physiological stress parameters. The 2 groups were comparable with respect to the anthropometric data as well as the initial values of all other parameters. Patients receiving DC reported significantly better quality of sleep in the night before the operation. There was no difference between DC and P concerning preoperative stress either emotionally or physiologically. The postoperative pain intensity did not differ between the two groups. The quality of premedication, assessed by the observer, was comparable in both groups. Whereas DC has a positive effect on the quality of sleep in preoperative patients, it does not influence the preoperative stress on the day of operation. This might be dose-dependent, but 20 mg is recommended for premedication.(ABSTRACT TRUNCATED AT 250 WORDS)
尽管二钾氯氮卓(DC)被广泛用于口服术前用药,但很少有研究能可靠地证明这种药物在术前患者中的效果。因此,在一项双盲研究中,我们对比了DC与安慰剂,研究了DC对术前睡眠、应激及术后疼痛的影响,DC具有长效抗焦虑特性,推测其会影响术后疼痛。60例接受牙科手术的患者在手术前一晚及早上7点分别口服20mg DC或安慰剂。使用名义量表和视觉模拟量表评估睡眠质量、术前焦虑、抑郁、乏力及术后疼痛。由麻醉医生评估镇静程度和术前用药质量。记录血压和心率并作为生理应激参数进行分析。两组在人体测量数据以及所有其他参数的初始值方面具有可比性。接受DC的患者报告术前一晚睡眠质量明显更好。DC组和安慰剂组在术前情绪或生理应激方面无差异。两组术后疼痛强度无差异。观察者评估的术前用药质量在两组中相当。虽然DC对术前患者的睡眠质量有积极影响,但它不影响手术当天的术前应激。这可能与剂量有关,但推荐术前用药剂量为20mg。(摘要截断于250字)