Ravnborg M, Hasselstrøm L, Ostergård D
Acta Anaesthesiol Scand. 1986 Feb;30(2):132-8. doi: 10.1111/j.1399-6576.1986.tb02383.x.
It has been postulated that esophageal retention of diazepam tablets is a problem of clinical significance, and that rectal administration is an advantageous alternative. To test this hypothesis, 100 patients were randomly allocated to premedication with either 15 mg diazepam orally or 10 mg diazepam as a rectal solution. A double dummy technique was used. A sedative effect was seen in 23 (50%) of the patients premedicated by mouth (O-group), but only in eight (20%) of those premedicated rectally (R-group) (P less than 0.05). Four patients (9%) in the O-group and seven (18%) in the R-group were unacceptably anxious before induction (n.s.). The plasma concentrations in the tablet group were nearly twice the concentrations found in the rectal-solution group, but no correlation between premedication effect and plasma concentration was found. Timing of premedication was very inaccurate, and this favored oral administration because of a more prolonged effect. No evidence of persistent esophageal retention was found.
据推测，地西泮片剂在食管内滞留是一个具有临床意义的问题，而直肠给药是一种有利的替代方法。为了验证这一假设，将100例患者随机分为两组，一组口服15mg地西泮进行术前用药，另一组直肠给予10mg地西泮溶液。采用双盲双模拟技术。口服术前用药组（O组）23例（50%）患者出现镇静效果，而直肠术前用药组（R组）仅8例（20%）出现镇静效果（P<0.05）。O组4例（9%）患者和R组7例（18%）患者在诱导前焦虑程度过高，无法接受（无显著性差异）。片剂组的血浆浓度几乎是直肠溶液组的两倍，但未发现术前用药效果与血浆浓度之间存在相关性。术前用药时间非常不准确，由于口服给药效果持续时间更长，这有利于口服给药。未发现食管持续滞留的证据。
