Zalunardo M P, Ivleva-Sauerborn A, Seifert B, Spahn D R
Institut für Anästhesiologie, Universitätsspital Zürich, Rämistr. 100, 8091 Zürich, Schweiz.
Anaesthesist. 2010 May;59(5):410-8. doi: 10.1007/s00101-010-1695-9.
Premedication aims at alleviating preoperative anxiety and nervousness and also at minimizing adverse effects. To our knowledge there is no study comparing efficacy and patient satisfaction of different premedications in age-adjusted dosage.
In 139 patients anxiety, sedation and adverse effects were measured at 6 consecutive perioperative time points after administration of midazolam, clonidine or a placebo.
Midazolam showed the strongest sedative and anxiolytic effects, clonidine less and placebo none. Clonidine and midazolam reduced the risk of postoperative nausea and vomiting (PONV). Midazolam showed minimal adverse effects and the best patient satisfaction.
Midazolam was the most anxiolytic, sedative and favored premedication with the least adverse effects. Most patients would choose midazolam next time.
术前用药旨在减轻术前焦虑和紧张情绪，并将不良反应降至最低。据我们所知，尚无研究比较不同术前用药在按年龄调整剂量时的疗效和患者满意度。
对139例患者在给予咪达唑仑、可乐定或安慰剂后，在围手术期连续6个时间点测量焦虑、镇静和不良反应。
咪达唑仑显示出最强的镇静和抗焦虑作用，可乐定作用较弱，安慰剂无作用。可乐定和咪达唑仑降低了术后恶心和呕吐（PONV）的风险。咪达唑仑的不良反应最小，患者满意度最高。
咪达唑仑是最具抗焦虑、镇静作用且不良反应最少的首选术前用药。大多数患者下次会选择咪达唑仑。
