Failure of Intramuscularly Administered Lorazepam and Scopolamine-Morphine Premedication to Produce Amnesic Effects to Supplement Conduction Anaesthesia

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Abstract
Patients undergoing surgery under regional anesthesia often prefer to be sedated and do not later want to recall the procedure. Patients (121) scheduled for various surgical procedures under epidural, spinal, sacral, or brachial plexus blockades received 1 mg/kg of pethidine, 0.007 mg/kg of scopolamine plus 0.14 mg/kg of morphine, or 0.03 mg/kg or 0.06 mg/kg of lorazepam i.m. as preanesthetic medication before the operation. The patient''s self-assessments of degree of fatigue and apprehension were similar after each premedication when assessed before operation. Postoperative anxiety and confusion and need for postoperative care and supervision were greatest for 0.06 mg/kg of lorazepam. Significantly (P < 0.05 to P < 0.01) fewer patients given 0.06 mg/kg of lorazepam remembered different events and procedures carried out on them before and after operation than those given other premedications, but no significant differences were noted in patient''s ability to recall the performance of operation when asked on the following day. Of patients receiving 0.06 mg/kg of lorazepam 77, 63 and 57% remembered the start of blockade, performance of operation and stay in recovery room, respectively. I.v. sedation should be preferred to these i.m. administered premedications if drug-induced amnesia is sought to supplement local anesthetic techniques.

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