Oral Alprazolam Attenuates Preoperative Stress Responses to Regional Anesthesia.

Choi,  Jae Chan; Park,  Sang Kyu; Kim,  Soon Yul; Yoon,  Yeo Seung; Lee,  Kwang Ho; Lee,  Young Bok; Lim,  Hyun Kyo; Park,  Jong Taek; Lee,  Ji Yeon

doi:2007.52.2.132

Randomized Controlled Trial

Korean Journal of Anesthesiology 2007;52(2):132-137.
DOI: https://doi.org/10.4097/kjae.2007.52.2.132

Oral Alprazolam Attenuates Preoperative Stress Responses to Regional Anesthesia.

Jae Chan Choi, Sang Kyu Park, Soon Yul Kim, Yeo Seung Yoon, Kwang Ho Lee, Young Bok Lee, Hyun Kyo Lim, Jong Taek Park, Ji Yeon Lee

¹Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. soonyul@yonsei.ac.kr
²Department of Orthopaedic Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.

Abstract

BACKGROUND
Preoperative anxiety activates the hypothalamo-pituitary-adrenal axis and the sympathetic nervous system, and also affects immune responses. Therefore, there is a need to reduce the anxiety.
METHODS
Forty-eight healthy patients scheduled for elective knee arthroscopic and reconstructive surgery under spinal anesthesia (SA) were randomly allocated into the control (CG, n = 24) and the alprazolam group (AG, n = 24). Oral 0.25 mg alprazolam in the evening before SA and 0.5 mg alprazolam 90 min before SA were administered to patients of the AG. Visual analogue scale (VAS) scores of anxiety were measured in the operating room before SA (ORSA) and operating room during operation and discharge day (DD). Serum ACTH and cortisol in the ORSA and DD, systolic and diastolic blood pressure and heart rate in the ward and ORSA, sleep time and number of night awakenings in the night before SA were measured.
RESULTS
Age (31.9 +/- 10.8 yr), sex, height, weight, and sleep time were not significantly different between the two groups. The number of night awakenings in the AG were significantly lower than in the CG. VAS scores of anxiety in the ORSA were significantly higher in the CG than in the AG. ACTH and cortisol levels in the CG were significantly higher in the ORSA than in the DD. ACTH and cortisol levels in the AG were not significantly different between the ORSA and the DD. Cortisol level in the ORSA were significantly lower in the AG than in the CG. Diastolic blood pressure and heart rate in the ORSA were significantly lower in the AG than in the CG.
CONCLUSIONS
These indicate that oral alprazolam attenuates preoperative stress responses to regional anesthesia.

Key Words: ACTH; alprazolam; cortisol; preoperative stress; spinal anesthesia