Effects of quazepam as a preoperative night hypnotic: comparison with brotizolam

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. 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. 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 ngxml(-1). 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.