Sublingual lorazepam: a better premedication?

The efficacy of a sublingual preparation of lorazepam was compared with an i.m. injection of lorazepam as premedication for 150 patients undergoing minor gynaecological surgery. Anxiety, arousability and recall of auditory, visual and tactile stimuli were used as measurements of the degree and rate of onset of the effects. Anxiety scores decreased in both groups after medication. Patients who received the drug sublingually showed less recall, an earlier onset of sedation, more drowsiness and a longer recovery time than those who received the drug i.m. It is concluded that lorazepam given by the sublingual route is superior to that given i.m. because of more rapid absorption resulting in earlier drowsiness and more amnesia. An additional advantage is the absence of the discomfort of an injection.