Research Article The Effect of the Kampo Medicine Yokukansan on Preoperative Anxiety and Sedation Levels Young-Chang Arai, 1,2 Jun Kawanishi, 1 Yoshikazu Sakakima, 1 Satoshi Sueoka, 1 Akihiro Ito, 1 Yusuke Tawada, 1 Yuki Maruyama, 1 Shinya Banno, 1 Hitomi Takayama, 1 Makoto Nishihara, 2 Takashi Kawai, 2 and Tatsunori Ikemoto 2 1 Department of Surgery, Toki General Hospital, Gifu 509-5193, Japan 2 Multidisciplinary Pain Centre, School of Medicine, Aichi Medical University, 21 Karimata, Nagakutecho, Aichigun, Aichi 480-1195, Japan Correspondence should be addressed to Young-Chang Arai; arainon@aichi-med-u.ac.jp Received 2 January 2014; Accepted 3 March 2014; Published 31 March 2014 Academic Editor: Kenji Watanabe Copyright © 2014 Young-Chang Arai et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Preoperative anxiety can lead to unfavorable physiological response such as tachycardia and hypertension. Prevention of preoperative anxiety improves surgical outcome and decreases inpatient stay. Yokukansan is one of prescriptions in Kampo, traditional Japanese herbal medicine, and is known to exert anxiolytic efects. Te aim of the present study was to compare the efects of diazepam and Yokukansan on preoperative anxiety, salivary amylase activity, and sedation levels. Methods. Seventy American Society of Anesthesiologists physical status I or II patients presenting for hemicolectomy under general anesthesia combined with epidural anesthesia were enrolled. Te Diazepam group received diazepam 5 mg orally and the Yokukansan group received Yokukansan 2.5 g orally. Results. Although levels of anxiety and salivary amylase activity were not diferent between the two groups, the modifed Observer’s Assessment of Alertness/Sedation Scale of the Yokukansan group was signifcantly higher compared to that of the Diazepam group. Conclusion. Yokukansan alleviated preoperative anxiety without undesirable sedation, when compared with diazepam. 1. Introduction Preoperative anxiety is a subjective symptom that can induce adverse efects on patients. Excessive anxiety is associated with unfavorable physiological response such as tachycardia and hypertension [1, 2]. And several studies showed that pre- vention of preoperative anxiety improved surgical outcome and decreased inpatient stay [1, 3]. Moreover, a number of studies have recommended the use of anxiolytic premedica- tion for reducing preoperative anxiety [1, 4]. Although ben- zodiazepines are efective in reducing preoperative anxiety, these drugs are accompanied by undesirable sedation [5]. Kampo, or traditional Japanese herbal medicine based on traditional Chinese herbal medicine, has been used for the treatment of diseases in Japan [6, 7]. Yokukansan is one of the Kampo prescriptions for screaming attacks, sleep terrors, and hypnic myoclonia in children [8]. Moreover, it has been used for the treatment of behavioral and psychiatric symptoms of dementia (BPSD) [8–10]. BPSD include delusions, hallucina- tions, anxiety, sleep problem, and many behavioral problems such as aggressive behavior. We hypothesized that the use of Yokukansan as premed- ication alleviates preoperative anxiety without undesirable sedation. In the present study, we therefore compared the efects of diazepam, one of benzodiazepines, and Yokukansan on preoperative anxiety, salivary amylase activity, and seda- tion levels. 2. Methods Afer obtaining approval from the Ethics Committees of Aichi Medical University, School of Medicine (a reference number: 13-097), and written informed patient’s consent, 70 American Society of Anesthesiologists physical status I or II patients presenting for hemicolectomy under general Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2014, Article ID 965045, 4 pages http://dx.doi.org/10.1155/2014/965045