Premedication for coronary angiography: effects on anxiety and hemodynamic status.
OBJECTIVE
This study was designed to compare the outcomes of two current methods of premedication, for coronary angiography with placebo, on the level of anxiety and hemodynamic status.


RESULTS
In all, 151 patients referring for coronary angiography were randomized into three groups with equal populations. The first group (group M) received 0.02 mg/kg intravenous midazolam; the second (group DP7rpar; received intramuscular injection of 5mg diazepam + 25 mg promethazine; and the third (group P) received 2cc of intravenous normal saline solution. Vital signs, blood pressure, and peripheral O2 saturation were recorded in specifically-designed questionnaires. The level of anxiety before and after angiography was documented according to the Visual Analog Scale. Patients in the group M accidentally had higher pre-procedural anxiety level (p < 0.05). There was no significant difference in pulse rate, respiratory rate, and mean blood pressure (BP) between these groups prior to angiography. In the group M, diastolic BP decreased more significantly than the other 2 groups during angiography (p < 0.05). Although number of punctures, pain at catheterization site, dose of lidocaine, level of consciousness, and patient satisfaction did not show a significant difference between the three groups; midazolam induced higher level of amnesia than the other 2 groups and the physicians were more satisfied with it only compared with diazepam + promethazine (p < 0.05).


CONCLUSIONS
Because of the importance of hemodynamic stability and comfort during angiography, non-pharmacologic approaches are preferred. In case of severity and persistence of autonomic system stimulation, the least effective dose of midazolam for a short period of time may be used.
Kazemisaeid
Ali
A
Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. mari_d81@yahoo.com
Zeinali
Alimohammad Haji
AH
Davoodi
Gholamreza
G
Amirzadegan
Alireza
A
Jam
Mohammad Saheb
MS
Dehkordi
Maria Raissi
MR
Azadbakht
Farnoosh
F
Abedini
Maryam
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D001007:Anxiety / Q000517:prevention & control*; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003975:Diazepam / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006634:Histamine H1 Antagonists / Q000008:administration & dosage; D006801:Humans; D007267:Injections; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D010147:Pain Measurement; D010919:Placebos; D011292:Premedication; D011398:Promethazine / Q000008:administration & dosage; D011795:Surveys and Questionnaires
D018686:Anesthetics, Intravenous; D006634:Histamine H1 Antagonists; D010919:Placebos; D011398:Promethazine; D003975:Diazepam; D008874:Midazolam