We found no evidence of a difference in time to discharge from hospital, assessed by clinical criteria, in patients who received anxiolytic premedication. However, in view of the age and variety of anaesthetic techniques used and clinical heterogeneity between studies, inferences for current day case practice should be made with caution.
Intravenous narcotics for premedication in outpatient anaesthesia.
One hundred adult female patients scheduled for outpatient laparoscopic procedures were studied. Each patient received intravenous premedication about 30 min before induction of anaesthesia. The premedications were given in a double-blind random order and were either a placebo, morphine (0.04 mg/kg), meperidine (0.35 mg/kg), fentanyl (0.75 microgram/kg) or sufentanil (0.15 microgram/kg). All patients received a standard anaesthetic regimen. Transient light-headedness was common following narcotic injections. Overall, sufentanil was superior to the placebo and to other narcotics in its ability to reduce preoperative anxiety and to provide more satisfactory induction, maintenance and recovery from anaesthesia. The incidence of postoperative nausea, vomiting and other side effects was not higher and discharge times were not longer after sufentanil compared to the placebo group. Complete recovery as assessed by telephone interview 24-48 h after the operation revealed no difference between the sufentanil and the other groups. The results of this study indicate that intravenous short-acting narcotics like fentanyl or sufentanil should be considered as an alternative premedicant for anxious patients who are scheduled for outpatient surgery.