Abstract
Purpose
The purpose of this study was to evaluate the effects of quazepam, a long-acting hypnotic, as a preoperative night medication in comparison with brotizolam, a shortacting hypnotic.
Methods
Two hundred patients (aged 30 to 70 years) admitted for elective general anesthesia at various hospitals were enrolled. Quazepam 15 mg, 30 mg, or 45 mg, or brotizolam 0.25 mg (40 patients each), was administered orally at 9 p.m. in the evening of the day before surgery. The control group (40 patients) did not receive any drugs. The quality of night sleep between the night during hospitalization and the night before surgery was compared by using a questionnaire. In the first 8 patients who received quazepam 15 mg, 30 mg, and 45 mg, the plasma concentrations of quazepam and its metabolites were measured 12 h after the drug administration, when the patients were brought into the operating room.
Results
In all the drug-administered groups, the speed of falling asleep, sleeping state, and feeling of freshness in the morning improved compared to the previous night and compared to the control group; the frequency of nocturnal awakening and dreaming decreased, and the total duration of sleep the night before surgery increased. Total duration of sleep was significantly longer in the groups with quazepam 30 mg and 45 mg than in the control and brotizolam 0.25 mg groups. No patients were drowsy with plasma concentrations of quazepam of 30 to 65 ng·ml−1.
Conclusion
The preoperative night hypnotics, quazepam and brotizolam improved sleep before surgery. As a preoperative night hypnotic, quazepam 30 mg and 45 mg increased the total duration of sleep compared to brotizolam 0.25 mg.
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References
A Van de Velde F Camu (1988) ArticleTitleEfficacy of lorazepam oral fast dissolving drug formulation (FDDF) in anesthesia premedication in adults: a double-blind placebo controlled comparison Acta Anaesthesiol Belg 39 95–100 Occurrence Handle3400411 Occurrence Handle1:STN:280:DyaL1c3ptFOmsg%3D%3D
T Nishiyama T Matsukawa K Hanaoka (1998) ArticleTitleThe effects of age and gender on the optimal premedication dose of intramuscular midazolam Anesth Analg 86 1103–1108 Occurrence Handle9585306 Occurrence Handle10.1097/00000539-199805000-00038 Occurrence Handle1:CAS:528:DyaK1cXjt12js7w%3D
F Ahmad P Rittmeyer E Goetzke J Koster (1983) ArticleTitleBrotizolam as a pre-operative hypnotic Br J Clin Pharmacol 16 419S–423S Occurrence Handle6362702
W Sieghart (1983) ArticleTitleSeveral new benzodiazepines selectively interact with benzodiazepine receptor subtype Neurosci Lett 38 74–78 Occurrence Handle10.1016/0304-3940(83)90113-1
PW Forrest (1982) ArticleTitleThe hypnotic activity of quazepam and placebo compared in presurgical patients Curr Ther Res 32 590–596
HK Uhthoff (1981) ArticleTitleA clinical study of quazepam in hospitalized patients with insomnia J Int Med Res 9 288–291 Occurrence Handle6114885 Occurrence Handle1:STN:280:DyaL3M3mtFKnsw%3D%3D
AN Nicholson BW Stone PA Pasco (1980) ArticleTitleStudies on sleep and performance with triazolo-1, 4-thienodiazepine (brotizolam) Br J Clin Pharmacol 10 75–81 Occurrence Handle7397057 Occurrence Handle1:CAS:528:DyaL3cXlsl2rsr4%3D
MB Scharf (1993) ArticleTitleFeasibility of an every-night regimen in insomniac patients: hypnotic effectiveness of quazepam, triazolam, and placebo J Clin Psychiatry 54 33–38 Occurrence Handle8428895 Occurrence Handle1:STN:280:DyaK3s7lsFSjtQ%3D%3D
MC Mauri S Gianetti L Pugnetti AC Altamura (1993) ArticleTitleQuazepam versus triazolam in patients with sleep disorders: a double-blind study Int J Clin Pharm Res 13 173–177 Occurrence Handle1:STN:280:DyaK2c%2FktFOltg%3D%3D
A Barnett LC Iorio E Ongini (1982) ArticleTitleThe sedative-hypnotic properties of quazepam, a new hypnotic agent Arzneimittel-Forschung 32 1452–1456 Occurrence Handle6129856 Occurrence Handle1:CAS:528:DyaL3sXks1OqtA%3D%3D
H Kawasaki M Urabe C Nuki R Yamamoto K Takasaki H Ohno (1987) ArticleTitleElectroencephalographic study with Sch 161 (quazepam), a new benzodiazepine hypnotic, in rats and rabbits Folia Pharmacol Japon 90 221–238 Occurrence Handle1:CAS:528:DyaL1cXltFI%3D
FR Freemon MSH Al-Marashi JCM Lee (1977) ArticleTitleThe effect of a new benzodiazepine on the polygraphically monitored sleep of normal volunteers J Clin Pharmacol 17 398–401 Occurrence Handle18491 Occurrence Handle1:CAS:528:DyaE2sXlt1Omt7o%3D
A Kales MB Scharf CR Soldatos EO Bixler SB Bianchi PK Schweitzer (1980) ArticleTitleQuazepam, a new benzodiazepine hypnotic: intermediate—term sleep laboratory evaluation J Clin Pharmacol 20 184–192 Occurrence Handle6103903 Occurrence Handle1:STN:280:DyaL3c3gsVymsQ%3D%3D
M Velasco F Velasco C Cepeda R Romo MA Perez-Toledo (1981) ArticleTitleEffect of a new thienodiazepine (We 941) on sleep patterns of normal and insomniac subjects Neuropharmacology 20 461–468 Occurrence Handle7017450 Occurrence Handle10.1016/0028-3908(81)90178-7 Occurrence Handle1:CAS:528:DyaL3MXlt1Kiu7k%3D
LG Miller WR Galpern JJ Byrnes DJ Greenblatt (1992) ArticleTitleBenzodiazepine receptor binding of benzodiazepine hypnotics: receptor and ligand specificity Pharmacol Biochem Behav 43 413–416 Occurrence Handle1359574 Occurrence Handle10.1016/0091-3057(92)90170-K Occurrence Handle1:CAS:528:DyaK38Xmt1KitLY%3D
JM Hilbert M Chung G Maier R Gural S Symchowicz N Zampaglione (1984) ArticleTitleEffect of sleep on quazepam kinetics Clin Pharmacol Ther 36 566–569 Occurrence Handle6478742 Occurrence Handle1:CAS:528:DyaL2MXht1w%3D Occurrence Handle10.1038/clpt.1984.220
JM Hilbert L Iorio V Moritzen A Barnett S Symchowicz N Zampaglione (1986) ArticleTitleRelationship of brain and plasma levels of quazepam, flurazepam, and their metabolites with pharmacological activity in mice Life Sci 39 161–168 Occurrence Handle3724367 Occurrence Handle10.1016/0024-3205(86)90451-0 Occurrence Handle1:CAS:528:DyaL28XktlGmtLc%3D
GD Aden C Thatcher (1983) ArticleTitleQuazepam in the short-term treatment of insomnia in outpatients J Clin Psychiatry 44 454–456 Occurrence Handle6361006 Occurrence Handle1:STN:280:DyaL2c%2FoslOntQ%3D%3D
MS Langley SP Clissold (1988) ArticleTitleBrotizolam. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy as an hypnotic Drugs 35 104–122 Occurrence Handle3281819 Occurrence Handle1:CAS:528:DyaL1cXhsl2gtbw%3D
WD Bechtel (1983) ArticleTitlePharmacokinetics and metabolism of brotizolam in humans Br J Clin Pharmacol 16 279S–283S Occurrence Handle6661373
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Nishiyama, T., Yamashita, K., Yokoyama, T. et al. Effects of quazepam as a preoperative night hypnotic: comparison with brotizolam. J Anesth 21, 7–12 (2007). https://doi.org/10.1007/s00540-006-0445-2
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DOI: https://doi.org/10.1007/s00540-006-0445-2