Preoperative anxiolysis and postoperative recovery in women undergoing abdominal hysterectomy

Background: Every year, millions of patients receive sedatives for reductio n of anxiety before surgery, but there is little objective data on the effe ct of this treatment on postoperative outcomes, To address this issue, the effects of benzodiazepine administration were evaluated hi women undergoing abdominal surgery. Methods: Patients were randomized to receive 1 mg of oral lorazepam the nig ht before surgery and 5 mg of intramuscular midazolam on the morning of sur gery (n = 34), or to receive a placebo the night before surgery and on the morning of surgery (n = 36). Postoperative pain (Visual Analogue Scale for pain, McGill Pain Questionnaire) and analgesic consumption (patient-control led analgesia), and clinical recovery parameters such as time to discharge from hospital mere evaluated after surgery. Results: Patient-controlled analgesia use showed a marginal main effect of treatment group (F(1,51) = 2.8; P = 0.047). Post hoc analysis demonstrated that patient-controlled analgesia consumption was significantly lower in th e treatment group only during the first 4 h of patient-controlled analgesia use after surgery (P = 0.027). There were no significant group differences at any later postoperative time points (P = not significant). There were n o group differences in the cumulative Percocet (Pfizer, New York, NY) consu mption in the postoperative period (P = not significant), Further, self-rep orted postoperative pain did not differ significantly between groups at any of the time points (P = not significant). There were also no group differe nces with regard to any postoperative clinical recovery parameters. Conclusions: Benzodiazepines administered before surgery have minimal benef icial effects on the postoperative clinical course of women undergoing abdo minal hysterectomy.