Benzodiazepines which are known to have beneficial effects with regard
to their anxiolytic action in premedication and their potentiating ef
fect in conjunction with a volatile or an intravenous type of anaesthe
sia, Due to the extensive investigation in regard to their mode and si
te of action, it is known that they bind to specific receptor sites in
selective brain areas, Also, it is known that different ligands have
different potencies which is derived from their difference in affinity
to their binding site, Their wide margin of safety and the existence
of a highly specific antagonist make this group of compounds relativel
y safe in cases of a potential overdose, However, as a regular prescri
ption medication, especially in women over the age of 50, potentiation
of anaesthesia has to be anticipated in patients with a history of tr
anquilizer intake, Especially a so called low-dose dependency, often n
ot considered important in premedical evaluation, may result in unexpe
cted cardiovascular reactions and more so in an overhang of anaestheti
cs with an ensueing respiratory depression, But more important is a po
tential withdrawal syndrome in the postoperative period which may resu
lt in typical symptoms culminating in life-threatening epileptic seizu
res, Such an increased activity of the central nervous system is to be
treated immediately by the injection of a benzodiazepine or a barbitu
rate. The management of addictive disorders and especially that of a l
ow-dose benzodiazepine dependency, is by tapering down the dose over s
everal weeks, In elderly patients, the potential benefits of withdrawa
l from benzodiazepine dependency are outweighted by the negative side-
effects.