Effect of sedative premedication on patient experience after general anesthesia: a randomized clinical trial

JAMA : the Journal of the American Medical Association
Axel Maurice-SzamburskiPremedX Study Investigators

Abstract

Sedative premedication is widely administered before surgery, but little clinical evidence supports its use. To assess the efficacy of sedative premedication on perioperative patient experience. A randomized clinical trial, the PremedX study, enrolled 1062 adult patients who were younger than 70 years and had been scheduled for various elective surgeries under general anesthesia at 5 French teaching hospitals (in Marseille, Montpellier, Nimes, and Nice) between January 2013 and June 2014. Neurosurgery, obstetrical, cardiac, and outpatient surgery were excluded. Patients were randomized to 3 groups of 354 participants each to receive 2.5 mg of lorazepam, no premedication, or placebo. The primary outcome was perioperative patient experience assessed 24 hours after surgery with a validated questionnaire (Evaluation du Vécu de l'Anesthésie Generale; EVAN-G) describing 6 domains of satisfaction and a global index (score range, 0-100; high scores represent high satisfaction); secondary outcomes included time to extubation and early cognitive recovery. A subgroup analysis was planned a priori in patients with a high level of preoperative anxiety. Premedication with lorazepam did not improve the EVAN-G mean global index for overall lev...Continue Reading

Citations

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