Anxiolysis

Question 1

What are the contraindications to premedication with Benzodiazepines

Answer 1

Newborns
Elderly
Dec level of consciousness
Intracranial pathology
Severe pulmonary disease
Hypovolaemia

Question 2

In which patients is anxiolysis indicated

Answer 2

Children - especially at preschool age due to severe separation anxiety
Anxious patients
Learning difficulties

Question 3

What are the benefits of providing pre-operative anxiolysis

Answer 3

Significant inverse relationship between anxiety and smoothness of induction of anaesthesia
Reduces emergence agitation
Reduces induction agent requirement

Question 4

What non-pharmacological forms of anxiolysis have been shown to be effective

Answer 4

Pre-operative visit by an anaesthetist immediately prior to surgery
Explanation of procedures
Pre-operative and intraoperative care provided by the same anaesthetist
Toys for children
Watching age appropriate movie clips for children

Question 5

What pharmacological agents can be used for preoperative anxiolysis

Answer 5

Benzodiazepines - Midazolam PO, IV, IN
  Diazepam, Temazepam, Lorazepam, Alprazolam - PO
a2 agonists - Clonidine
Ketamine
Fentanyl - IN, SL

Question 6

What are the common adverse effects of Midazolam

Answer 6

Agitation after PO Midaz
Hiccups
Non-significant decrease in psychomotor function

Question 7

List the benzodiazepines in order of duration of action (shortest to longest)

Answer 7

Midazolam, Oxazepam, Alprazolam, Temazepam/Lorazepam, Clonazepam, Diazepam