COMPARISON OF THE EFFICAY OF CHLORMETHIAZOLE AND DIAZEPAM AS I.V.SEDATIVES FOR SUPPLEMENTATION OF EXTRADURAL ANAESTHESIA

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Abstract
The clinical efficacy of two sedative agents was compared in 21 young healthy patients undergoing surgery under extradural blockade. A state of sedation and amnesia in which patients lapsed into a sleep-like state when left undisturbed, yet spontaneously opened their eyes to make comments and co-operate with verbal commands, was sought. This was achieved readily by careful titration of responses and required a diazepam loading dose of 20 (± 15) mg given at a rate of 1 mg min-1 or 0.8% chlormethiazole edisylate infusion 10 ml min-1 given over 16 (±6) min. Control of this state was easier with chlormethiazole (by varying the rate of infusion) than by giving repeated doses of diazepam. Both agents provided good anterograde amnesia; there was no retrograde amnesia. Considerable postoperative somnolence with a high incidence of relapse into amnesic and sedated states were noted with both agents. However, if the total volume of chlormethiazole infused was less than 300 ml, then ±a distinct advantage of abrupt and lucid recovery was apparent. Blood concentrations producing the desired clinical state were more variable for diazepam than for chlormethiazole.

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