March 25, 2015 – Premedication

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Anchor lead:  Should medicine for anxiety be given before surgery? Elizabeth Tracey reports

Sometimes people are so anxious before surgery they are given a medication to help.  Now a new study reported in the Journal of the American Medical Association concludes that the practice may cause people to have to stay on a breathing machine longer, and doesn’t result in greater patient satisfaction.  Joseph Califano, a head and neck surgeon at Johns Hopkins, comments.

Califano: A benzodiazepine would be the most common agent to premedicate patients.  The fact that it would take them longer to extubate implies that there would be more incremental risk associated with the procedure and that would make the whole procedure a little bit less efficient.  A study like this would indicate that premedication is certainly not a desired strategy and one that is useful for patients, so this does have some impact.  However there are going to be cases where patients, because they have significant anxiety, really can benefit from selective premedication.  :30

A delay to previous levels of cognitive function may also be seen with premedication.  At Johns Hopkins, I’m Elizabeth Tracey.