TY - JOUR
T1 - Safety of Oral Midazolam as a Perioperative Anxiolytic for Outpatient Dermatologic Procedures
AU - Bezalel, Spencer A.
AU - Brewer, Jerry D.
AU - Baum, Christian L.
AU - Arpey, Christopher J.
AU - Roenigk, Randall K.
AU - Otley, Clark C.
N1 - Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - BACKGROUNDPerioperative anxiety can negatively impact patient satisfaction and can complicate outpatient dermatologic procedures.OBJECTIVEEvaluate adverse events associated with oral midazolam as a perioperative anxiolytic during dermatologic surgery and assess whether an enhanced monitoring approach is associated with an increased detection rate.MATERIALS AND METHODSFive hundred cases (250 before and after change in monitoring) where patients were administered oral midazolam between July 2015 and May 2017 were retrospectively reviewed. The number of procedures, type of procedures, dose in milligrams, number of doses, major and minor adverse events, and vital signs were recorded.RESULTSThe difference in number of treatment sites, types of procedures, and total dose administered was not significant. There were minor but significant differences in the mean change in blood pressure, heart rate, respiratory rate, and Richmond Agitation and Sedation Scale score before and after the procedure but not oxygen saturation. These vital sign changes were not clinically significant. There were zero major adverse events in both groups. There were 2 patients who became transiently hypoxic.CONCLUSIONOral midazolam administration was not associated with major adverse events including in the more intensively monitored group. This supports its use as an anxiolytic for outpatient dermatologic procedures.
AB - BACKGROUNDPerioperative anxiety can negatively impact patient satisfaction and can complicate outpatient dermatologic procedures.OBJECTIVEEvaluate adverse events associated with oral midazolam as a perioperative anxiolytic during dermatologic surgery and assess whether an enhanced monitoring approach is associated with an increased detection rate.MATERIALS AND METHODSFive hundred cases (250 before and after change in monitoring) where patients were administered oral midazolam between July 2015 and May 2017 were retrospectively reviewed. The number of procedures, type of procedures, dose in milligrams, number of doses, major and minor adverse events, and vital signs were recorded.RESULTSThe difference in number of treatment sites, types of procedures, and total dose administered was not significant. There were minor but significant differences in the mean change in blood pressure, heart rate, respiratory rate, and Richmond Agitation and Sedation Scale score before and after the procedure but not oxygen saturation. These vital sign changes were not clinically significant. There were zero major adverse events in both groups. There were 2 patients who became transiently hypoxic.CONCLUSIONOral midazolam administration was not associated with major adverse events including in the more intensively monitored group. This supports its use as an anxiolytic for outpatient dermatologic procedures.
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U2 - 10.1097/DSS.0000000000002624
DO - 10.1097/DSS.0000000000002624
M3 - Article
C2 - 32826600
AN - SCOPUS:85097004534
SN - 1076-0512
VL - 46
SP - 1588
EP - 1592
JO - Dermatologic Surgery
JF - Dermatologic Surgery
IS - 12
ER -