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The effect of diazepam on methohexitone short anaesthesia: a clinical doable-blind investigation

Matti A. K. Manila, HM Larni

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Abstract

A double-blind investigation was performed on 113 adult females, hospitalized for short gynaecological procedures, in order to establish the suitability of methohexitone for short procedures and whether or not the quality of methohexitone anaesthesia could be improved with a diazepam supplement. All patients were anaesthetized with methohexitone (2.0 mg/kg): 57 of the patients received a 10 mg diazepam intravenous supplement and 56 received intravenous placebo (solvent of diazepam only). Diazepam injected after induction with methohexitone clearly improved the quality of methohexitone anaesthesia (p less than 0.1 more than 0.05) and reduced the need for supplementary doses of methohexitone (p less than 0.1 more than 0.05). The incidences of both nausea and vomiting were minimized (p less than 0.01 more than 0.001). Patient acceptance was equally good in both groups. It is commented that patients may seem fully awake and oriented, notwithstanding the fact that the body still contains significant amounts of the anaesthetic agent. Ambulatory patients should never be allowed to leave the hospital unescorted, as they recover their 'street-orientation' only after 12 to 24 hours. Furthermore, the patients or their escorts should be given definite and written instructions to avoid absolutely the use of alcohol or hypnotics which could, even in small amounts, potentiate the effect of methohexitone still in the body, for at least 12 hours. It is recommended that patients should avoid driving a motor vehicle or using dangerous tools or machines for 12 to 24 hours following recovery from methohexitone anaesthesia.

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What this paper is about

A double-blind investigation was performed on 113 adult females, hospitalized for short gynaecological procedures, in order to establish the suitability of methohexitone for short procedures and whether or not the quality of methohexitone anaesthesia could be improved with a diazepam supplement. All patients were anaesthetized with methohexitone (2.0 mg/kg): 57 of the patients received a 10 mg diazepam intravenous supplement and 56 received intravenous placebo (solvent of diazepam only). Diazepam injected after induction with methohexitone clearly improved the quality of methohexitone anaesthesia (p less than 0.1 more than 0.05) and reduced the need for supplementary doses of methohexitone (p less than 0.1 more than 0.05). The incidences of both nausea and vomiting were minimized (p less than 0.01 more than 0.001). Patient acceptance was equally good in both groups. It is commented that patients may seem fully awake and oriented, notwithstanding the fact that the body still contains significant amounts of the anaesthetic agent. Ambulatory patients should never be allowed to leave the hospital unescorted, as they recover their 'street-orientation' only after 12 to 24 hours. Furthermore, the patients or their escorts should be given definite and written instructions to avoid absolutely the use of alcohol or hypnotics which could, even in small amounts, potentiate the effect of methohexitone still in the body, for at least 12 hours. It is recommended that patients should avoid driving a motor vehicle or using dangerous tools or machines for 12 to 24 hours following recovery from methohexitone anaesthesia.

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Available abstract

A double-blind investigation was performed on 113 adult females, hospitalized for short gynaecological procedures, in order to establish the suitability of methohexitone for short procedures and whether or not the quality of methohexitone anaesthesia could be improved with a diazepam supplement. All patients were anaesthetized with methohexitone (2.0 mg/kg): 57 of the patients received a 10 mg diazepam intravenous supplement and 56 received intravenous placebo (solvent of diazepam only). Diazepam injected after induction with methohexitone clearly improved the quality of methohexitone anaesthesia (p less than 0.1 more than 0.05) and reduced the need for supplementary doses of methohexitone (p less than 0.1 more than 0.05). The incidences of both nausea and vomiting were minimized (p less than 0.01 more than 0.001). Patient acceptance was equally good in both groups. It is commented that patients may seem fully awake and oriented, notwithstanding the fact that the body still contains significant amounts of the anaesthetic agent. Ambulatory patients should never be allowed to leave the hospital unescorted, as they recover their 'street-orientation' only after 12 to 24 hours. Furthermore, the patients or their escorts should be given definite and written instructions to avoid absolutely the use of alcohol or hypnotics which could, even in small amounts, potentiate the effect of methohexitone still in the body, for at least 12 hours. It is recommended that patients should avoid driving a motor vehicle or using dangerous tools or machines for 12 to 24 hours following recovery from methohexitone anaesthesia.

Key concepts: Medicine, Diazepam, Anesthesia, Methohexital, Nausea, Vomiting, General anaesthesia, Placebo

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