Hewitt J M, Barr A M
Br J Anaesth. 1978 Nov;50(11):1149-54. doi: 10.1093/bja/50.11.1149.
Lorazepam 3 or 4 mg i.m. was given to 100 patients as premedication before bronchoscopy under thiopentone-suxamethonium anaesthesia. Forty-nine of the patients assessed as anxious received oral lorazepam as preoperative night sedation also. Lorazepam was an effective night sedative. Forty-two of the 49 patients slept well and were calm and co-operative in the morning. Following the i.m. injection of lorazepam, 64% of patients had complete lack of recall for 4--10 h following premedication. Only 5% recalled correctly a simple objective test of memory initiated in the anaesthetic room. The frequency of recall was higher in those who consumed alcohol regularly and in females. There was one case of awareness during bronchoscopy in a patient who received only a small dose of lorazepam (2.8 mg per 70 kg). Side-effects were minimal and patient acceptance was impressive. These results show an advance on previous studies using pethidine and diazepam. Further improvement is needed, particularly in adjusting the dose of lorazepam to body weight and to factors such as age, sex and alcohol intake.
在硫喷妥钠-琥珀胆碱麻醉下进行支气管镜检查前,对100例患者给予3或4毫克的劳拉西泮肌肉注射作为术前用药。49例被评估为焦虑的患者术前夜间也口服劳拉西泮作为镇静剂。劳拉西泮是一种有效的夜间镇静剂。49例患者中有42例睡眠良好,早晨平静且配合。肌肉注射劳拉西泮后,64%的患者在术前用药后4至10小时完全无记忆。只有5%的患者能正确回忆起在麻醉室进行的一项简单记忆客观测试。经常饮酒者和女性的回忆频率较高。一名仅接受小剂量劳拉西泮(每70公斤2.8毫克)的患者在支气管镜检查期间出现了一例知晓情况。副作用极小,患者接受度良好。这些结果表明比之前使用哌替啶和地西泮的研究有进步。需要进一步改进,特别是在根据体重以及年龄、性别和酒精摄入量等因素调整劳拉西泮剂量方面。