ORAL GABAPENTIN AND LORAZEPAM AS PREMEDICATION IN PEDIATRIC ANESTHESIA: A RANDOMIZED COMPARATIVE STUDY

Abstract

Background: Preoperative anxiety in children can affect anesthetic induction, physiological stability, and postoperative outcomes. Lorazepam is a widely used benzodiazepine for anxiolysis, while gabapentin, although not commonly used in children, has shown potential anxiolytic effects. Methods: This double-blind randomized controlled trial included 64 children aged 2–6 years who underwent elective procedures under general anesthesia. Subjects were randomly assigned to receive either oral gabapentin (15 mg/kg) or lorazepam (0.025 mg/kg). Preoperative anxiety was assessed using the Modified Yale Preoperative Anxiety ScaleShort Form (mYPAS-SF), while secondary outcomes included sedation, measured by the Ramsay Sedation Scale (RSS), and parental separation, assessed using the Parental Separation Anxiety Scale (PSAS). Results: No significant reduction in anxiety scores was observed in either group (gabapentin: p = 0.29; lorazepam: p = 0.76). Optimal sedation occurred in 75% of lorazepam and 56.2% of gabapentin recipients. Inadequate separation and higher rescue sedation needs were more frequent in the gabapentin group. No moderate-to-severe adverse events were reported within 24 hours post-administration. Conclusion: Neither drug significantly reduced preoperative anxiety scores, however, both demonstrated potential as part of pediatric premedication strategies. Gabapentin remains a promising alternative as premedication, particularly in specific clinical settings.

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