SAFETY AND EFFECTIVENESS OF AN ORAL PREMEDICATION REGIMEN BEFORE CARDIAC-SURGERY

Thirty-five adult cardiac surgical patients received 20 mg dipotassium clorazepate orally the evening before surgery and 2 mg flunitrazepam 60 min before induction of anaesthesia. If anaesthesia was to be induc ed after 08.30 hours patients received an additional 20 mg dipotassium clorazepate at 06.15 hours. The following measurements were made: per ipheral arterial oxygen saturation (Spo(2)) breathing room air; anxiet y by visual analogue scale; degree of sedation; and haemodynamic varia bles. Mean (SpO(2)) was 95.9% (SD 1.8%) on the day before surgery and 95.4% (SD 1.5%) on arrival at the operating room. When the operation s tarted after 08.30 hours, mean (Spo(2)) at 09.00 hours was 96.0% (SD 1 .4%). There were no detected episodes of hypoxaemia after premedicatio n. Mean anxiety score decreased significantly from 3.9 (SD 2.6) on the day before surgery to 3.3 (SD 2.1) on arrival at the operating room ( patients' score; P<0.002) and from 4.6 (SD 2.4) to 3.3 (SD 2.0) (anaes thesiologists' score; P<0.001). Nearly all patients were considered we ll sedated, which was reflected by normal haemodynamic variables on ar rival at the operating room. The combination of clorazepate and flunit razepam is effective oral premedication for adult cardiac surgery, cau sing no obvious desaturation even when supplemental oxygen is not give n.