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Aim <p>Pre-operative anxiety is an unpleasant state in patients undergoing any surgical procedures. A pre-surgical medication may improve patients’ comfort, increase efficacy &amp; safety of anaesthetic agents, and relieves pain. Aim of the study was to evaluate the effect of pre-surgical oral alprazolam administration on serum cortisol levels in patients undergoing surgical removal of impacted mandibular third molar tooth under local anaesthesia.</p> Materials and methods <p>One hundred patients consented to get removal of unilateral impacted mandibular third molar tooth under lignocaine 2% with adrenaline (1:2,00,000) were included in the study. Venous blood samples to estimate serum cortisol levels were taken 2 days before surgery (baseline), immediately before pre-surgical medication (alprazolam 0.5&#xa0;mg, PO), intra-operatively and 2&#xa0;h after surgery.</p> Results <p>A total of 100 patients were included, with most aged 25–30 years (32%) and a slight female predominance (53%). Mean serum cortisol levels increased significantly from the baseline value of 9.45 ± 3.77&#xa0;µg/dL to 17.33 ± 4.80&#xa0;µg/dL immediately before pre-medication (<i>p</i> &lt; 0.001). Following alprazolam administration, intra-operative cortisol levels decreased significantly to 8.51 ± 3.75&#xa0;µg/dL (<i>p</i> &lt; 0.001), and subsequently increased to 11.70 ± 6.59&#xa0;µg/dL two hours post-operatively (<i>p</i> &lt; 0.001). All cortisol values remained within physiological limits throughout the study.</p> Conclusion <p>Single-dose oral alprazolam 0.5&#xa0;mg given pre-operatively reduced serum cortisol levels, a surrogate marker of anxiety. It is recommended to include tablet alprazolam 0.5&#xa0;mg as pre-surgical medication in the protocol for removal of impacted mandibular third molar tooth.</p>

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Effect of Pre-surgical Oral Administration of Alprazolam on Serum Cortisol Levels in Patients Undergoing Impacted Mandibular Third Molar Tooth Removal Surgery

  • 期刊论文

  • 发表日期：

    2026年1月19日

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  • Neeraj Bansal,
  • Pravesh Mehra,
  • Akanshya Loshali,
  • Harmeet Singh Rehan,
  • Ekta Debnath

摘要

Aim

Pre-operative anxiety is an unpleasant state in patients undergoing any surgical procedures. A pre-surgical medication may improve patients’ comfort, increase efficacy & safety of anaesthetic agents, and relieves pain. Aim of the study was to evaluate the effect of pre-surgical oral alprazolam administration on serum cortisol levels in patients undergoing surgical removal of impacted mandibular third molar tooth under local anaesthesia.

Materials and methods

One hundred patients consented to get removal of unilateral impacted mandibular third molar tooth under lignocaine 2% with adrenaline (1:2,00,000) were included in the study. Venous blood samples to estimate serum cortisol levels were taken 2 days before surgery (baseline), immediately before pre-surgical medication (alprazolam 0.5 mg, PO), intra-operatively and 2 h after surgery.

Results

A total of 100 patients were included, with most aged 25–30 years (32%) and a slight female predominance (53%). Mean serum cortisol levels increased significantly from the baseline value of 9.45 ± 3.77 µg/dL to 17.33 ± 4.80 µg/dL immediately before pre-medication (p < 0.001). Following alprazolam administration, intra-operative cortisol levels decreased significantly to 8.51 ± 3.75 µg/dL (p < 0.001), and subsequently increased to 11.70 ± 6.59 µg/dL two hours post-operatively (p < 0.001). All cortisol values remained within physiological limits throughout the study.

Conclusion

Single-dose oral alprazolam 0.5 mg given pre-operatively reduced serum cortisol levels, a surrogate marker of anxiety. It is recommended to include tablet alprazolam 0.5 mg as pre-surgical medication in the protocol for removal of impacted mandibular third molar tooth.