title: The effect of premedication on preoperative anxiety.
abstract: The aim of this study was to evaluate the effect of premedication on anxiety, cortisol, residual gastric volume and gastric pH. Following the approval of the institutional Clinical Research Ethics Committee, 100 patients in ASA I-II scheduled for elective gynecologic surgery, were included into a double blind study. Patients were randomly allocated into two groups; the placebo and the premedicated. Oral 10 mg diazepam in the evening before surgery and 1.5 mg midazolam at least 15 min before surgery. The same anesthetic procedure was applied for both groups. Anxiety levels of patients were assessed by using Spielberger State-Trait Anxiety Inventory Scale (STAIs). Blood samples for cortisol measurements were obtained at the preoperative visits, preanesthesia and intraoperative phases. Gastric contents were collected through an orally inserted gastric tube, acidity was measured by using Merck's pH paper. In placebo group, the preanesthetic STAIs values were increased compared to the values obtained at preoperative visit (p < 0.001). The preanesthetic STAIs values were decreased in premedicated group (p < 0.001). The changes of preanesthetic and preoperative visit values were statistically different (p < 0.001). The preanesthetic and intraoperative cortisol values were increased in both groups compared to values of preoperative visit. The augmentation was significantly higher in the placebo group (p < 0.05). Positive correlation was observed between basal state anxiety and basal cortisol values and preanesthetic STAIs and cortisol values in the placebo group (r = 0.325, p < 0.05). These data support that preoperative sedation suppresses the preoperative anxiety and the cortisol augmentation resulting from surgery and stress.
authors.affiliation: Hacettepe Univ. Faculty of Med., Department of Anesthesia and Reanimation, Ankara, Turkey.
authors.forename: Memnune
authors.initials: M
authors.lastname: Pekcan
authors.forename: Bilge
authors.initials: B
authors.lastname: Celebioglu
authors.forename: Basaran
authors.initials: B
authors.lastname: Demir
authors.forename: Fatma
authors.initials: F
authors.lastname: Saricaoglu
authors.forename: Gulsen
authors.initials: G
authors.lastname: Hascelik
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Yukselen
authors.forename: Elif
authors.initials: E
authors.lastname: Basgul
authors.forename: Ulku
authors.initials: U
authors.lastname: Aypar
mesh_terms: D000293:Adolescent; D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy*; D003975:Diazepam / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005745:Gastric Acidity Determination; D005750:Gastric Juice / Q000187:drug effects; D013509:Gynecologic Surgical Procedures / Q000523:psychology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D011292:Premedication / Q000379:methods* / Q000706:statistics & numerical data; D011300:Preoperative Care / Q000379:methods*; D011594:Psychometrics / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents; D003975:Diazepam; D008874:Midazolam; D006854:Hydrocortisone