comparison of the effect of lorazepam and chlordiazpoxide as premedication on prevention of recall perioperative events after general anesthesia

Premedication is used for preparing patients before operation in order to induce sedation, homodynamic stability, analgesia, and prevention of nausea and vomiting. The side effects of the drugs and amnesia also need consideration. The purpose of this study was to compare the effect of Lorazpam and Chlordiazpoxide as premedication in prevention of recall perioperative events, following general anesthesia. This clinical trial was carried out during October 1997 to March 1999 on 128 adult patients who had inclusion criteria and were randomly assigned to two groups. The patients in group 1 each received 2mg lorazpam and in group 2 each received l0mg chlordiazpoxide at night before operation and again at the morning of operation. Twenty-four hours after operation, all patients were asked about perioperative events and then scores of amnesia were specified for all patients of the two groups. The data were analyzed by U-Mann Whitney and chi-square tests. The patients ranged between 20 to 50 years of age. The mean age in group 1 [Lorazpam] and group 2 [chlordiazpoxide] were 38 +/- 3.9 and 39.3 +/ 2.8, respectively [P>0.05]. The results showed that Lorazpam group recalled perioperative events were less than those of chlordiazpoxide group [P<0.05]. It was found that induced amnesia with Lorazpam was significantly more than that of chlordiazpoxide, suggesting that Lorazpam may be preferable as a premedication before operation

comparison of effects of lidocaine 5% lidocaine 5% plus pethidine 5% and pethidine 5% in spinal anesthesia for cesarean section

Spinal anesthesia for elective cesarean section using drugs such as lidocaine has long been used with reports of various complications. To reduce these complications, many methods such as administration of sympathetic stimulating drugs like ephedrine, and using other drugs including pethidine have been recommended. The present study was aimed to evaluate comparatively the effects of separate and combined administration of pethidine and lidocaine on spinal anesthesia in candidates for cesarean surgery. In this double blind clinical trial study, 150 cases with ASA I - II and full term neonatal, candidate for elective cesarean surgery from Zahedan Ghods Hospital and AH-Ebene-Abitaleb Hospital, were subjected to the study during 2001-2004. They were randomly divided into three groups of 50, for using 5% lidocaine, 5% lidocaine plus 5% pethidine and 5% pethidine, respectively. A number of variables, including duration of postoperative analgesia, variation of homodynamic, heart rate, hypotension, nausea and vomiting were assessed. Statistical descriptive methods, one way AN OVA and X[2] were used for the data analysis. Breath depression was not seen in the neonates. The Apgar score was >/= 8. Duration of post operating analgesia was 453 minutes in pethidine group, 344.3 minutes in lidocaine plus pethidine group and 141.4 minutes in lidocaine group with significant differences [P<0.05]. Differences of nausea and vomiting between groups were not significant. The longest duration of analgesia was seen with pethidine usage. The combination of pethidine and lidocaine was intermediately effective and seems to be suitable choice in anesthesia comparing to lidocaine alone