Impact of preoperative anxiolytic on surgical site infection in patients undergoing abdominal hysterectomy.
BACKGROUND
An increased anxiety may be associated with a higher risk of surgical site infection (SSI), but there is little objective data on the effect of preoperative anxiolytic interventions on SSI. To address this issue, we evaluated the effects of preoperative diazepam on postoperative SSI following abdominal hysterectomy.


METHODS
This randomized, double-blinded, placebo-controlled study included 130 patients, American Society of Anesthesiologist physical status 1 or 2. Patients were randomly assigned to receive either oral diazepam 10 mg (n = 65) or placebo (n = 65) the night before and 1 hour prior to surgery. The assessment instruments were the Visual Analogue Scale and the State-Trait Anxiety Inventory. SSI was diagnosed according to the criteria of the Centers for Disease Control and Prevention with standard follow-up of 30 days.


RESULTS
The relative risk (RR) was 1.79 (95% confidence interval [CI]: 1.31-2.43), and the number of patients that needed to be treated was 5.2 (95% CI: 2.74-50.76) to prevent 1 additional SSI. The RR for SSI in placebo-treated patients with high postoperative anxiety was 1.65 (95% CI: 1.07-2.56).


CONCLUSIONS
Diazepam-treated patients showed lower postoperative anxiety and lower incidence of SSI up to 30 days after surgery compared with placebo in patients undergoing abdominal hysterectomy.
Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Rosa
R
Levandovski
Maria Beatriz Cardoso
MB
Ferreira
Maria Paz Loayza
MP
Hidalgo
Cássio Alves
CA
Konrath
Daniel Lemons
DL
da Silva
Wolnei
W
Caumo
D000328:Adult; D016058:Analgesia, Patient-Controlled; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000517:prevention & control*; D003975:Diazepam / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D015994:Incidence; D016015:Logistic Models; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology; D011300:Preoperative Care; D012306:Risk; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*
D014151:Anti-Anxiety Agents; D003975:Diazepam