Comparison of Efficacy of Oral Escitalopram and Alprazolam as Premedication in Craniotomy Surgeries for Primary Brain Tumors

Keywords

alprazolam - escitalopram - anterograde amnesia

Introduction: Reduction in anxiety and fear at preoperative period in patients of elective surgery is essential for surgical preparation. To allay the anxiety is among one of the most important components in neuroanesthesia practice. Our aim is to compare the efficacy and safety profile of drugs escitalopram and alprazolam as preoperative medication.

Methodology/Description: Forty patients aged between18 and 60, scheduled for elective craniotomy surgery were included in this comparative study. Patients were randomly allocated into two groups of 20 each. Patients received tab. 5 mg escitalopram in Group E and tab. 0.5 mg alprazolam in Group A orally, 8 hours and 2 hours prior to surgery. Assessment of efficacy variables: anxiety, hemodynamic variables, sedation, postoperative pain, and anterograde amnesia. Anxiety was assessed using Amsterdam Preoperative Anxiety and Information Scale (APAIS). Pain was assessed using Visual Analog Scale (VAS).

Results: It was found that there was a significant difference in mean anxiety levels pre- and postoperative periods in both groups. Immediately before taking to operation theater, that is, 2 hours after drug administration, 5 patients in Group E were more anxious as compared with nine patients in Group A. Patients in Group E were more sedated in the postoperative period with better anterograde amnesia. There was no significant difference in pain scores in both the groups.

Conclusion: The inference drawn by the present study is that orally administered escitalopram produced superior anxiolysis, sedation, and anterograde amnesia compared with orally administered alprazolam.

 

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• References

• 1 Baldwin DS, Reines EH, Guiton C, Weiller E. Escitalopram therapy for major depression and anxiety disorders.. Ann Pharmacother 2007; 41 (10) 1583-1592
• 2 Choi JC, Park SK, Kim SY. et al. Oral alprazolam attenuates preoperative stress responses to regional anesthesia.. Korean J Anesthesiol 2007; 52: 132-137