TY - JOUR
T1 - Premedication to reduce anxiety in patients undergoing coronary angiography and percutaneous coronary intervention
AU - Vlastra, Wieneke
AU - Rohling, Wim J.
AU - Wagenaar, Tineke C.
AU - Hirsch, Alexander
AU - Meesterman, Martin G.
AU - Vis, Marije M.
AU - Wykrzykowska, Joanna J.
AU - Koch, Karel T.
AU - de Winter, Robbert J.
AU - Baan, Jan
AU - Piek, Jan J.
AU - Sprangers, Mirjam A. G.
AU - Henriques, José P. S.
PY - 2018
Y1 - 2018
N2 - Aims In this study, we examined the effects of the routinely administration of benzodiazepines on reducing periprocedural anxiety versus no premedication. Methods In this open label study, we enrolled 1683 patients undergoing diagnostic coronary angiograms (CAG) or percutaneous coronary interventions (PCI). Randomisation was simulated by systematically allocating patients in monthly rotational periods to lorazepam 1mg/sl, oxazepam 10mg/po, diazepam 5mg/po, midazolam 7.5mg/po or no premedication. Anxiety was measured at four different time points using the one-item Visual Analogue Scale for Anxiety (VAS score) ranging from 0 to 10. The primary outcome was the difference in anxiety reduction (VAS, preprocedure to postprocedure), between the different premedication strategies versus no premedication. Results Anxiety reduction was larger in patients premedicated with lorazepam (2.0, SE=1.6, P=0.007) or diazepam (2.0, SE=1.5, p=0.003) compared with patients without any premedication (1.4, SE=1.2). The use of midazolam or oxazepam did not lead to a significant reduction in anxiety compared with patients who did not receive premedication. Additionally, a high number of patients treated with midazolam (N=39, 19.8%) developed side effects. Conclusions In this study, the use of lorazepam or diazepam was associated with a significant, but modest anxiety reduction in patients undergoing CAG or PCI. This study does not support the standard use of oxazepam or midazolam as premedication to reduce anxiety.
AB - Aims In this study, we examined the effects of the routinely administration of benzodiazepines on reducing periprocedural anxiety versus no premedication. Methods In this open label study, we enrolled 1683 patients undergoing diagnostic coronary angiograms (CAG) or percutaneous coronary interventions (PCI). Randomisation was simulated by systematically allocating patients in monthly rotational periods to lorazepam 1mg/sl, oxazepam 10mg/po, diazepam 5mg/po, midazolam 7.5mg/po or no premedication. Anxiety was measured at four different time points using the one-item Visual Analogue Scale for Anxiety (VAS score) ranging from 0 to 10. The primary outcome was the difference in anxiety reduction (VAS, preprocedure to postprocedure), between the different premedication strategies versus no premedication. Results Anxiety reduction was larger in patients premedicated with lorazepam (2.0, SE=1.6, P=0.007) or diazepam (2.0, SE=1.5, p=0.003) compared with patients without any premedication (1.4, SE=1.2). The use of midazolam or oxazepam did not lead to a significant reduction in anxiety compared with patients who did not receive premedication. Additionally, a high number of patients treated with midazolam (N=39, 19.8%) developed side effects. Conclusions In this study, the use of lorazepam or diazepam was associated with a significant, but modest anxiety reduction in patients undergoing CAG or PCI. This study does not support the standard use of oxazepam or midazolam as premedication to reduce anxiety.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85054373387&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30275956
U2 - https://doi.org/10.1136/openhrt-2018-000833
DO - https://doi.org/10.1136/openhrt-2018-000833
M3 - Article
C2 - 30275956
SN - 2053-3624
VL - 5
JO - Open Heart
JF - Open Heart
IS - 2
M1 - e000833
ER -