Conscious sedation and analgesia for routine aortofemoral arteriography: a prospective evaluation.
OBJECTIVE
To compare the effectiveness of temazepam and midazolam hydrochloride with or without fentanyl citrate versus a placebo in promoting patient acceptance of diagnostic aortofemoral arteriography.


METHODS
One hundred twenty-five patients undergoing aortofemoral arteriography were prospectively and randomly assigned to one of four treatment arms: placebo (group A), oral temazepam (group B), intravenous midazolam (group C), or intravenous midazolam and fentanyl (group D). Patients were blinded to the administered sedative. Five-point scales were used to assess degree of patient discomfort, willingness to undergo the same procedure again, patient compliance, and preprocedural anxiety.


RESULTS
There was no difference between patient groups in willingness to return for a repeat procedure (P: =.89). Group C patients were less compliant during the procedure (P: =.034). Mean patient discomfort scores were 1.81 for group A, 1.84 for group B, 1. 53 for group C, and 1.27 for group D. Discomfort experienced during the procedure was not related to the degree of preprocedural anxiety (P: =.42). Patients who had previously undergone arteriography reported a higher level of pain than did those who had not (P: =. 021).


CONCLUSIONS
Most patients experienced only low-level discomfort during diagnostic aortofemoral arteriography. In the authors' opinion, conscious sedation should only be used selectively, not routinely, for diagnostic aortofemoral arteriography.
Kennedy
P T
PT
Department of Radiology, the Royal Victoria Hospital, Belfast, Northern Ireland. ptkennedy@classicfm.net
Kelly
I M
IM
Loan
W C
WC
Boyd
C S
CS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid; D014151:Anti-Anxiety Agents; D001027:Aortography; D016292:Procedural Sedation; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D005283:Fentanyl; D006801:Humans; D006993:Hypnotics and Sedatives; D007511:Ischemia / Q000000981:diagnostic imaging; D007866:Leg / Q000098:blood supply; D008297:Male; D008874:Midazolam; D008875:Middle Aged; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D013693:Temazepam
D000701:Analgesics, Opioid; D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D013693:Temazepam; D008874:Midazolam; D005283:Fentanyl