Meds Before Surgery

187541883Let's face it.  For most patients surgery is a nerve-wracking experience.  Enter then the practice of providing preoperative anti-anxiety medications to keep people calmed down before general anesthesia is employed.  But what of this practice?  Does it help or does it result in other outcomes that aren't desirable?  As Rick and I discuss on PodMed this week, that's the gist of a study in JAMA this week.  Basically the study shows that compared with either placebo or no medication, patients were no more satisfied with their experience when given lorazepam prior to surgery than either placebo or nothing.  They did however take longer to get off the ventilator and to recover cognitive function early.  Hmmm.  Sounds like the practice should be abandoned except perhaps in the very, very anxious, the only group who did seem to benefit in this study.  And as I comment in the podcast, this is a timely topic as factors that may end in delirium for elderly surgical patients are being scrutinized, and this may well contribute.

Other topics this week include improved air quality and growth of lungs in adolescents in NEJM, drugs to cope with shift work in JAMA, and the dangers of testosterone supplements per an FDA warning.  Until next week, y'all live well.

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