Use of Oral Bromazepam as Premedicant and it’s Effects in Peri-operative Period - A Comparative Study with Oral Diazepam

Abstract

Anaesthetic management begins with the pre operative psychological preparation of the patient and administration of a drug or drugs selected to produce specific pharmacological responses prior to the induction of anaesthesia. Preoperative medication should increase the likelihoods that patient will enter the preoperative period free from apprehension, sedated but easily arousable and fully co-operative. A prospective randomized controlled trial was performed in adult patient of different surgical approach to see the effectiveness of bromazeparn as a premedicant and the haemodynarnic changes in patients at perioperative period. Ninety patients of ASA grade I and II, aged 20 to 50 years of both sexes undergoing different type of surgery under general anaesthesia of 30 to 150 minutes duration and were divided randomly into three groups. Control group (Group-C) has no medication preoperatively. Group-D were given oral diazepam 5 mg at night before the operation and 5 mg at morning on the day of operation and Group- B were given bromazeparn 3 mg at night before and 3 mg at morning on the day of operation. Observations were carried in during preoperative assessment on the day before surgery, in the anaesthetic room at morning, before induction and in postoperative ward (after extubation). Anxiety level was measured by Visual Analogue Scale (VAS), which was reduced significantly at morning on the day of operation, before induction and 24 hrs after operation in Group-B (p< 0.001). Pulse rate, blood pressure (systolic and diastolic) at different time in perioperative period (in Group-D and group Group-B) was stable in comparison to Group-C (p<0.001). Sedation score that was measured at morning on the day of operation before induction in different groups was seen and found that in Group-D, (36.66%) patients were drowsy but responds to verbal commands in comparison to Group-B (6.66%) (p<0.001). Recovery statuses were measured by Aldrete Recovery Score and have seen recovery scores was better in bromazepam taken group (73.33%) in comparison to diazepam taken group (56.66%). Postoperatively nausea was more in diazepam taken group (20.00%) than bromazepam taken group (16.16%). It was concluded that oral bromazepam at divided dose as a premedicant relief anxiety, and patients are haemodynamically stable in perioperative period with a well recovery.  

Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.22-30