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Lorazepam and diazepam as adjuncts to epidural anaesthesia for caesarean section

Abstract

Lorazepam 0.05 mg.kg-1 and diazepam 0.1 mg.kg-1 administered intravenously were compared as sedatives for 42 patients undergoing Caesarean Section under epidural anaesthesia. After receiving the drug, 15 per cent of the diazepam patients and 32 per cent of the lorazepam patients were still agitated. Ten per cent of the diazepam patients and 36 per cent of the lorazepam patients had severe symptoms of delirium. These included hallucinations, confusion, agitation, restlessness, inappropriate weeping and repetitive hand movements. Memory impairment was greater with lorazepam. Thirty-five per cent of the diazepam patients had pain at the injection site. None of the lorazepam patients had such pain. Respiratory rate, heart rate and mean blood pressure did not change significantly in either group. Half the patients who had been given lorazepam had side effects that were bothersome enough to cause them to complain the following day. Lorazepam and diazepam were both unsatisfactory as sedatives for patients having Caesarean Section.

Résumé

On a comparé l’effet sédatif du lorazepam 0.05 mg.kg-1 et du diazepam 0.1 mg.kg-1 sur 42 patientes subissant une césarienne sous anesthésie épidurale. Après administration de la drogue, 15 pour cent des patientes ayant reçu le diazepam et 32 pour cent le lorazepam étaient toujours agitées alors que 10 pour cent des patientes au diazepam et 36 pour cent des malades au lorazepam manifestaient des symptômes importants de délire, incluant hallucinations, confusion, agitation, pleurs sans raison et mouvements répétitifs. La perte de mémoire fut plus importante avec le lorazepam. Trente-six pour cent des patientes au diazepam ont éprouvé de la douleur au site d’injection contre aucune au lorazepam. La fréquence respiratoire, cardiaque et la tension artérielle moyenne n’ont pas changé de façon significative pour les deux groupes. La moitié des patientes qui avaient reçu du lorazepam ont éprouvé des effets secondaires désagréables assez importants pour qu’elles s’en plaignent le lendemain. Le lorazepam et le diazepam sont tous deux considérés comme non satisfaisants pour la sédation pendant la césarienne.

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Correspondence to B. Y. Ong or B. G. Pickering or R. J. Palahniuk or M. Cumming.

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Ong, B.Y., Pickering, B.G., Palahniuk, R.J. et al. Lorazepam and diazepam as adjuncts to epidural anaesthesia for caesarean section. Canad. Anaesth. Soc. J. 29, 31 (1982). https://doi.org/10.1007/BF03007945

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Key Words

  • Hypnotics
  • diazepam
  • lorazepam
  • Anaesthesia
  • obstetrical
  • Anaesthetic Techniques
  • epidural
  • Surgery
  • Caesarean Section.