Premedication with Benzodiazepines: Postoperative Outcomes

Abstract

Introduction: Premedication is the administration of medication before the induction of anaesthesia. Benzodiazepines (BZD) have anxiolytic effects and causes sedation and anterograde amnesia. Premedication with BZD has become questionable regarding possible postoperative side effects such as postoperative delirium (POD) (incidence 1% – 48%), complications in cardiovascular and respiratory systems. Aim of the Study: To compare the postoperative outcome of BZD-premedicated patients in two groups: first (1st) group – those that are not using these drugs regularly and second (2nd) group – regular users. Materials and Methods: A retrospective cohort study of 96 adult patients who have received premedication with BZD at Hospital of Lithuanian University of Health Sciences Kaunas Clinics from 2019 to 2020. POD diagnosis was confirmed by psychiatrist. Data analysis was accomplished using the SPSS 28.0 program. Fisher’s Exact Test was applied. The statistically significant difference was, when p<0,05. Results: 78.1% were female, 21.9% – male. All patients underwent hip replacement surgery, received spinal anaesthesia and were premedicated with Midazolam. The 1st group consisted of 73 patients with average age 55.58 (SD=19.09), the 2nd – 23 patients with average age 67.13 (SD=7.65). 87.0% patients in the 2nd group were taking Lorazepam, 13.0% - Diazepam. There were no postoperative respiratory depression and hypotension. 5.21% patients had POD. 80% of the patients that experienced POD were from the 2nd group. POD had a higher incidence in patients that were taking BZD regularly (p=0,011). Conclusions: 5.21% of study subjects have experienced POD. POD had a higher incidence in patients that were taking BZD regularly (p=0,011). There were no signs of cardiovascular and respiratory postoperative side effects, such as hypotension and respiratory depression.