Oral premedication with benzodiazepines

Preoperative medication or premedication is the administration of medications before surgery, to reduce anxiety, which is common in these patients, and as prophylaxis of side effects of anesthesia like heart rhythm disorders, blood pressure variations, hypersalivation, etc. Benzodiazepines are the usual agents used in premedication to provide relief of anxiety, anterograde amnesia, and light sedation. The most common benzodiazepines used for premedication are midazolam, Diazepam and lorazepam. They are usually given intramuscularly or orally in children. The time of use should be correlated with the moment of maximum effect depending on the method of administration. Time varies from twenty minutes for intramuscularly administered midazolam to two hours for peroral administered lorazepam. The choice of a particular Benzodiazepine, used for premedication, depends on its effects, duration of action, active metabolites, and side effects. The dose should be carefully tailored to provide the expected reduction of anxiety and light sedation and to avoid sleep and especially respiratory depression.