title: Effects of oral diazepam on intravenous access in same day surgery patients.
abstract: OBJECTIVE
  To determine the effects of 5 mg oral diazepam on vein quality, patient anxiety, and intravenous (i.v.) access.
  
  
  METHODS
  Prospective, randomized, double-blind, placebo controlled study.
  
  
  METHODS
  Preoperative holding area of a large university hospital.
  
  
  METHODS
  202 adult ASA physical status I, II, and III patients scheduled for elective outpatient surgery.
  
  
  METHODS
  Patients were randomized to receive either 5 mg oral diazepam or placebo, 30 minutes prior to i.v. access.
  
  
  RESULTS
  Vein quality and patient anxiety were assessed prior to, and 30 minutes following, premedication (just prior to venipuncture) using a 5 point ordinal scale and 10 cm visual analog scale, respectively. The number of attempts at venous access and the gauge of the catheter used were also recorded. Baseline patient anxiety was similar between the two groups and both showed a significant improvement in patient anxiety at 30 minutes following drug administration. The diazepam group, however, had a significantly greater reduction in anxiety scores (p < 0.05). There were no differences in baseline vein quality between the two groups; however, the quality of the vein was subjectively improved following diazepam administration. The mean number of attempts at i.v. access between the diazepam group (1.26 +/- 0.56) and the placebo group (1.32 +/- 0.65) was not significantly different. However, the ability to place larger gauge catheters was significantly enhanced in the diazepam group.
  
  
  CONCLUSIONS
  The administration of 5 mg oral diazepam prior to the establishment of i.v. access improved vein quality and decreased patient anxiety. This technique may be a useful method for i.v. catheter placement, particularly when large gauge catheters are required, or when difficult i.v. access is anticipated.
authors.affiliation: Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor 48109, USA.
authors.forename: M I
authors.initials: MI
authors.lastname: Wittenberg
authors.forename: T L
authors.initials: TL
authors.lastname: Lark
authors.forename: C L
authors.initials: CL
authors.lastname: Butler
authors.forename: R M
authors.initials: RM
authors.lastname: Handy
authors.forename: H D
authors.initials: HD
authors.lastname: Schwanky
authors.forename: A R
authors.initials: AR
authors.lastname: Tait
authors.forename: K K
authors.initials: KK
authors.lastname: Tremper
mesh_terms: D000759:Adjuvants, Anesthesia / Q000627:therapeutic use*; D000328:Adult; D000556:Ambulatory Surgical Procedures; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D003975:Diazepam / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011446:Prospective Studies
chemical_list: D000759:Adjuvants, Anesthesia; D014151:Anti-Anxiety Agents; D003975:Diazepam