ANXIOLYTIC EFFECT OF MIDAZOLAM PREMEDICATION ASSESSED BY CLINICAL AND PLATELET AGGREGATION PROFILES
Abstract
Background: It is well documented that surgery is associated with increased anxiety, which has anadverse impact on patient’s outcome. This study was designed to assess the anxiolytic effect ofmidazolam in pre-anaesthetic medication by using clinical and platelet aggregation profiles.Methods: Sixty ASA I and II female patients aged between 35 and 60 years undergoing electiveabdominal hysterectomy were randomly divided into two equal groups. Group I received placebo aspre-medication while group II received 0.15 mg/kg midazolam as pre-medication 1 hourpreoperatively. They were monitored for visual analogue scale (VAS) for anxiety, observer’s anxietycriteria, sedation score, blood pressure, heart rate and platelet aggregation profile immediately beforeand 1 hour after pre-medication. Results: There was statistically significant difference with respectto VAS of anxiety, observer’s anxiety criteria, sedation scores, systolic and diastolic blood pressure(p<0.05). Heart rate was higher in the midazolam group but this was not statistically significant.There was no statistical significant difference in platelet aggregation profile in the two groups.Conclusion: Findings of the study suggest midazolam is a good anxiolytic for pre-medication and itseffect on platelet aggregation profile needs to be further evaluated.Keywords: Pre-medication, Widazolam, Anxiolysis, Platelet aggregationReferences
Welsh J. Reducing patient stress in theatre. Alison Bell
Memorial Award. Br J Perioper Nurs 2000;10:321–4, 326–7.
Norris W, Baird WL. Pre-operative anxiety: A study of the
incidence and aetiology. Br J Anaesth 1967;39:503–9.
Mitchell M. Patient anxiety and modern elective surgery: a
literature review. J Clin Nurse 2003;12:806–15.
Carr E, Brockbank K, Allen S, Strike P. Patterns and
frequency of anxiety in women undergoing gynaecological
surgery. J Clin Nurs 2006;15: 341–52.
White PF. Pharmacologic and clinical aspects of preoperative
medication. Anesth Analg 1986;65:1021–8.
Reves JG, Fragen RJ, Vinik HR, Greenblatt DJ. Midazolam:
pharmacology and uses. Anesthesiology 1985;62:310–24.
Exton JH. Mechanism involved in alpha adrenergic
phenomena. Am J Physiol 1985;248:E633–47.
Begent NA, Born GV. Quantitative investigation of
intravascular platelet aggregation. J Physiol
;210(1):40P–41P.
Vinik HR, Reves JG, Greenblatt DJ, Abernethy DR, Smith
LR. The pharmacokinetics of midazolam in chronic renal
failure patients. Anesthesiology 1983;59:390–4.
J Ayub Med Coll Abbottabad 2010;22(2)
http://www.ayubmed.edu.pk/JAMC/PAST/22-2/Ehtesham.pdf 7
Forrest P, Galletly DC, Yee P. Placebo controlled
comparison of midazolam, triazolam and diazepam as oral
premedicants for outpatient anaesthesia. Anesth Intensive
Care 1987;15(3):296-304.
Marty J Gauzit R, Lefevre P, Couderc E, Farinotti R, Henzel
C, Desmonts JM. Effect of diazepam and midazolam on
baroreflex control of heart rate and on sympathetic activity in
humans. Anaesth Analg 1986;65(2):113–9.
Wood M, Wood AJ. Drugs and Anaesthesia Baltimore:
Williams & William;1990.p.179–223
May J, Loesche W, Heptinstall S. Glucose increases
spontaneous platelet aggregation in whole blood. Thrombosis
Research 1990;59:489–95.
Hardeman M.R, Vreeken J, Goedhart P.T, Oosting P.R.
Transient aggregation resistance of human blood platelets in
fresh plasma. Thrombosis Res 1989;54:719–31.
Ho CH, Chan IH. The influence of time of storage,
temperature of storage, platelet number in platelet-rich
plasma, packed cell, mean platelet volume, Hemoglobin
concentration, age and sex on platelet aggregation test. Ann
Hematol 1995;71:129–33.
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