title: Comparison of the efficacy of chlormethiazole and diazepam as i.v. sedatives for supplementation of extradural anaesthesia.
abstract: The clinical efficacy of two sedative agents was compared in 21 young healthy patients undergoing surgery under extradural blockade. A state of sedation and amnesia in which patients lapsed into a sleep-like state when left undisturbed, yet spontaneously opened their eyes to make comments and co-operate with verbal commands, was sought. This was achieved readily by careful titration of responses and required a diazepam loading dose of 20 (+/- 15) mg given at a rate of 1 mg min-1 or 0.8% chlormethiazole edisylate infusion 10 ml min-1 given over 16 (+/- 6) min. Control of this state was easier with chlormethiazole (by varying the rate of infusion) than by giving repeated doses of diazepam. Both agents provided good anterograde amnesia; there was no retrograde amnesia. Considerable postoperative somnolence with a high incidence of relapse into amnesic and sedated states were noted with both agents. However, if the total volume of chlormethiazole infused was less than 300 ml, then a distinct advantage of abrupt and lucid recovery was apparent. Blood concentrations producing the desired clinical state were more variable for diazepam than for chlormethiazole.
mesh_terms: D000759:Adjuvants, Anesthesia; D000328:Adult; D000647:Amnesia / Q000139:chemically induced; D000767:Anesthesia, Epidural; D002719:Chlormethiazole / Q000008:administration & dosage / Q000097:blood; D003975:Diazepam / Q000008:administration & dosage / Q000097:blood; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D007263:Infusions, Parenteral; D008297:Male; D013997:Time Factors
chemical_list: D000759:Adjuvants, Anesthesia; D006993:Hypnotics and Sedatives; D002719:Chlormethiazole; D003975:Diazepam