title: Lorazepam given the night before surgery reduces preoperative anxiety in children undergoing reconstructive burn surgery.
abstract: A high level of preoperative anxiety frequently occurs in children undergoing reconstructive burn surgery. Reduction of this anxiety may have a number of physiological and psychological benefits. Various pharmaceutical and nonpharmaceutical regimens to reduce preoperative anxiety have been devised; however, most regimens are not initiated until the period immediately before surgery. Many of the children in our institution report high levels of anxiety beginning the night before surgery. Therefore we hypothesized that sedation the night before surgery would be beneficial. Oral lorazepam 0.025 mg/kg or placebo was given the night before surgery to 45 patients in a prospective, randomized, double-blind fashion; in addition, all patients received preoperative sedation per protocol on the day of surgery. Immediately before induction of anesthesia, all patients (mean age 12.5 +/- 0.9 years, range 6 to 18 years) performed an anxiety self-rating with the use of a validated visual analog scale (VAS). Patient anxiety and quality of anesthesia induction was also rated by one of the investigators. Postoperatively, patients rated their recall of anxiety with the use of the VAS. When queried preoperatively, patients who received lorazepam the night before surgery self-reported significantly less anxiety than those receiving placebo. Investigator observations did not detect this difference; this reinforces the assertion that patient self-rating of anxiety may be the best tool for rating anxiety.
authors: Department of Anesthesiology, Shriners Hospital for Children-Cincinnati, Ohio 45229, USA.
authors: J E
authors: JE
authors: McCall
authors: C G
authors: CG
authors: Fischer
authors: G
authors: G
authors: Warden
authors: R
authors: R
authors: Kopcha
authors: S
authors: S
authors: Lloyd
authors: J
authors: J
authors: Young
authors: B
authors: B
authors: Schomaker
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000517:prevention & control*; D002056:Burns / Q000601:surgery*; D016009:Chi-Square Distribution; D002648:Child; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008140:Lorazepam / Q000627:therapeutic use*; D008297:Male; D011292:Premedication; D011300:Preoperative Care; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods / Q000523:psychology; D012016:Reference Values; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents; D008140:Lorazepam