[Stress reduction by i.m. premedication with 6 different single substances].

In three prospective randomized studies six substances for intramuscular premedication were investigated and compared to placebo (NaCl 0.9%): diazepam (10-20 mg), flunitrazepam (1-2 mg), droperidol (2.5-5 mg), triflupromazin (10-20 mg), pethidin (50-100 mg) and buprenorphin (0.15-0.3 mg). The effects on preoperative stress were evaluated with psychometrical methods (ESB), heart rate, blood pressure and plasma-cortisol levels. Degree of sedation and side effects were recorded. Good effects on anxiety were found after flunitrazepam, diazepam and triflupromazin. The worst effects were found after droperidol and pethidin. Good effects on depression were found after pethidin, buprenorphin, diazepam and triflupromazin. The worst effects were found after droperidol. Asthenic patients were improved with diazepam and flunitrazepam, but deteriorated after placebo, pethidin, triflupromazin and droperidol. The physiological stress parameters were positively influenced by diazepam and flunitrazepam, but not after placebo and droperidol. Nausea and vomitus were found after buprenorphin, pethidin and droperidol; psychological and neurological problems occurred after droperidol. The highest degree of sedation was found after flunitrazepam, diazepam and droperidol. The day after surgery the patients found placebo, flunitrazepam, diazepam and triflupromazin to be the best premedications, pethidin and buprenorphin were inferior and droperidol was the poorest premedication.