Patient Experience

Maurice-Szamburski et al. Effect of Sedative Premedication on Patient Experience After General Anesthesia: A Randomized Clinical Trial. JAMA. 2015;313(9):916-925. doi:10.1001/jama.2015.1108

Bottom line: 

Multi-centre randomized control trial of 1062 patients for elective surgery under general anesthesia. Administration of pre-operative lorazepam, compared with placebo and no pre-medication, did not improve self-reported patient experience on POD 1. The authors concluded there is insufficient evidence to support routine use of lorazepam as a pre-medication in the perioperative period.

Major points:

1. Sedative premedication with lorazepam compared with placebo or no premedication did not improve the self-reported patient experience the day after surgery

2. Lorazepam was associated with modestly prolonged time to extubation and a lower rate of early cognitive recovery

​3. In a subgroup analysis of the most anxious patients, no significant differences were found in self reported patient satisfaction between the lorazepam group and the no premedication group or the placebo group