Lorazepam And Alprazolam Comparative Study

Comparative Study of Lorazepam and Alprazolam as Premedication For Patient Posted For Orthopaedic Surgery.

Introduction
The main aim of premedication is to allay anxiety, block autonomic reflexes, produce amnesia, facilitate induction of anaesthesia, reduce stress response to anaesthesia and provide analgesia, if necessary. Anxiety of surgery is associated with various neuroendocrine changes1 like elevation of cortisol, epinephrine, growth hormone, and adrenocorticotropic hormone in serum. For anxiolysis and lessen the psychological effects of hospital experiences, prior to anaesthesia, premedication was administered.2 Most commonly, non parenteral route is preferred for initiation of sedation and premedication administration in the clinical

Lorazepam can also be used as premedication for anxiolysis at a dose of 2 mg as bolus and its elimination half life is 13.8 hrs. Though Lorazepam onset of action is delayed, it produces a constant sedative effect on the CNS when bolus dose precedes a continuous infusion. This property of lorazepam made available in the critical care medicine.5

Aim
To compare the safety and efficacy of Lorazepam over a well-established premedication, Alprazolam, in producing sedation and anxiolysis effects.
Objectives
1. To determine and compare the sedative and anxiolytic effects of orally administered Alprazolam and Lorazepam in control and treatment group at time intervals of 30, 60 and 90 minutes.
2. To determine and compare the degree of psychomotor and cognitive impairment that may have resulted from the administration of Alprazolam and lorazepam.
3. To determine and compare the quality of recovery from the anesthetic administered with the Alprazolam and Lorazepam as premedication.

According to Schweizer E et al.,Sixty-seven patients with panic disorder were treated with single-blind placebo for one week before being randomized to 6 weeks of double-blind treatment with either lorazepam or alprazolam. Both drugs showed significant and comparable antipanic efficacy throughout the course of the study. With the exception of sedative effects, both drugs were well-tolerated at a mean daily dose of 7 mg for lorazepam and 3 mg for alprazolam. Lorazepam appeared to be as effective as alprazolam in the acute treatment of panic disorder.

Inclusion
Patients who are healthy (under ASA I & II) and about to undergo orthopaedic surgery are in included in this work. Age group between 18 and 55 years of both gender whose baseline VAS anxiety score of at least 40 mm are included. Patients who are given with premedication by oral route

Exclusion
Patients under ASA≥III are