Effects of routine premedication for cardiac catheterization on sedation, level of anxiety and arterial oxygen saturation.
OBJECTIVE
To assess the efficacy and side effects of routine premedication in patients undergoing cardiac catheterization procedures in a tertiary cardiac care institute. The criteria used included: arterial hemoglobin oxygen saturation (%SaO2), level of sedation and level of anxiety before and after the procedure. Overall patient satisfaction was also quantified.


METHODS
Sixty-two adult patients scheduled for cardiac catheterization procedures were recruited for the study. They were premedicated with one of several premedication regimens: oral diazepam 5 to 10 mg; oral lorazepam 1 mg; oral diazepam 10 mg+oral promethazine 25 mg; or oral diazepam 10 mg+oral diphenhydramine 25 mg. No attempt was made to control the premedication the patients received; it was ordered by each patient's cardiologist according to personal preference. Patients underwent pulse oximetry and evaluation of sedation, anxiety and level of satisfaction before and after cardiac catheterization.


RESULTS
All patients tested had values for mean precatheterization %SaO2 above 92%. No patient had postcatheterization %SaO2 readings below that defined as indicating clinically significant hypoxemia (%SaO2 less than 90%). Patients were awake or lightly sedated before and after cardiac catheterization. Thirteen per cent of patients suffered from high levels of anxiety before, and 16% during, cardiac catheterization. Twenty-three per cent of patients reported being dissatisfied with the premedication before, and 10% of patients reported being dissatisfied during, cardiac catheterization.


CONCLUSIONS
Clinically significant hypoxemia and oversedation are not problems for most patients given the types and doses of precatheterization medication used in the study population. The premedication schedules followed in the study failed to provide satisfaction and anxiolysis in a significant number of those studied.
Bergeron
P
P
Department of Anaesthesia, University of Ottawa Heart Institute, Ontario.
Enns
J
J
Delima
L
L
Dupuis
J Y
JY
Wynands
J E
JE
D000368:Aged; D001007:Anxiety / Q000517:prevention & control*; D001158:Arteries; D006328:Cardiac Catheterization; D016292:Procedural Sedation / Q000523:psychology; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D011292:Premedication
D006454:Hemoglobins; D006993:Hypnotics and Sedatives; D010100:Oxygen