Vol. 4, Issue 5 (2018)
Eszopiclone and zolpidem as a better alternate premedication to midazolam
Author(s): Dr. Reena Makhni, Dr. Joginder Pal Attri, Dr. Leena Mahajan, Dr. Sukhman Kaur, Dr. Neeru Bala
Abstract: Background and aim: Anxiety is one of the most common problem which affects the patient during surgical procedures. Thus, anxiolytics have a primary role as premedication preoperatively. With this background, we designed this study with primary objective of evaluation of sedation and anxiolysis with midazolam, zolpidem and eszopiclone as a premedication under regional anesthesia and to compare the satisfactory level of patients anxiety using Hamilton anxiety rating scale. Our secondary objective was to evaluate any adverse cardiovascular and respiratory events occurring due to use of these drugs. Methods: Study was carried out in 150 patients scheduled for regional anaesthesia and were divided into three groups of 50 each. Group M 50 patients were given midazolam 7.5 mg, Group Z of 50 patients were given zolpidem 15 mg, and group E of 50 patients were given eszopiclone 3 mg, 45 minutes before surgery with a sip of water. Monitoring of pulse rate, blood pressure, oxygen saturation and respiratory rate was done after giving premedication, every 5 minutes intraoperatively and every 15 minutes for 4 hours and every half hourly for 12 hours postoperatively. The results thus obtained were analysed using SPSS version 23.0 statistical package for windows. Results: Significant values of satisfactory scores between group M vs Z (p value - 0.00), group M vs E (0.00). HAM score at 90 minutes group M vs Z (0.018), group M vs E (0.003), at 120 minutes group M vs Z (0.00), group M vs E (0.00). Sedation score in group M vs Z at 1,4,6 hours (0.00), at 8 hours (0.002) and in group M vs E at 1 hour (0.00) at 4 hours (0.023) and in group Z vs E at 4hours (0.013), at 6 hours (0.00). All the three drugs reduce anxiety without altering the haemodynamics but zolpidem and eszopiclone have early onset of sleep and longer duration of sedation as compared to midazolam. Conclusion: zolpidem and eszopiclone are better premedication to allay anxiety in the patients undergoing regional anaesthesia.