In 104 patients undergoing anaesthesia of short duration, two different solvents, propylene glycol and cremophor, were compared in a double-blind trial. Diazepam 10 mg in a coded solution was injected into a superficial vein of the hand using a small-gauge needle. The vein was examined after 14 days. The frequency of thrombophlebitis with propylene glycol was 62.2% and with cremophor 3.4% (P less than 0.001). The frequency of pain on injection was also in favour of the new solvent (P less than 0.001). The possibility of anaphylactic reactions accredited to cremophor, however, restricts the use of the new injection.

The absorption of rectal diazepam solution was studied in 22 children aged 1-9 yr by measuring serum concentrations. The mean dose was 0.27 +/- 0.09 mgkg-1. The mean serum concentration was 98.5 +/- 53.5 ng ml-1 4 min after administration and 206.7 +/- 105.8 ng ml-1 at 11 min. The correlation between dose and serum concentration was statistically significant at both times. With a dose of 0.4-05 mgkg-1 an adequate serum concentration was achieved within 5-6 min. No side-effects were observed. A rectal solution provides a faster, more effective and reliable alternative to tablets and suppositories, and to the uncertain i.m. injection of diazepam. Meticulous nursing is important.

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Venous sequelae were studied in 93 female patients undergoing minor gynaecological procedures. They were premedicated with diazepam i. v. dissolved in a fat emulsion (Diazemuls) injected to a superficial vein of the right hand. The patients observed the site of injection for 14 days and recorded their findings. Twenty-eight per cent reported mild tenderness and 7.5% mild or moderate swelling of short duration. Signs of thrombophlebitis were found in 2.2%. Thrombophlebitis after injection can be prevented effectively and safely using fat emulsion as a solvent for diazepam.