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.
A novel approach to anxiolytic premedication for day-case patients.
The usefulness of 10 mg timolol orally as a non-sedative anxiolytic premedicant for day-case patients was examined in a double-blind placebo-controlled study. Patients were invited to take part by letter sent the week before gynaecological (n = 40) or oral (n = 60) surgery was scheduled. Indices of anxiety and alertness were obtained prior to administration of the tablet; quality of previous anaesthetic experience was also recorded. In those patients with no previous or unpleasant previous anaesthetic experience a significant reduction in anxiety amongst those given timolol was identified. Haemodynamic differences between the groups were not clinically significant, and return of psychomotor function was not delayed by timolol. Timolol effectively reduces situational anxiety, is non-sedative, and is advocated as a premedicant for anxious day-case patients and others in whom rapid return of psychomotor function is desirable.