Oral Medication With Diazepam or Midazolam Associated or Not With Clonidine for Oculoplastic Office Surgery Under Local Anesthesia

Alencar, Victor Marques de; Gonçalves, Rejane Dantas Rodrigues; Cruz, Antônio Augusto Velasco e

doi:10.1097/iop.0b013e3181c06546

Cited by 10 publications

(9 citation statements)

References 27 publications

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“…If systolic blood pressure (SBP) was greater than 180 mm Hg, 0.1 mg of clonidine was given, and the SBP was rechecked in 30 minutes to verify improvement. 7,10 If SBP was greater than 200 mm Hg or did not improve after administration of clonidine, the case was canceled. Our local anesthesia was standardized across the in-office and ambulatory surgery center (ASC) settings: 1:1:1 ratio of normal saline, 1% lidocaine with 1:100,000 epinephrine, and 0.5% bupivacaine with 1:200,000 epinephrine, with 0.5 ml of bicarbonate per 10 ml administered on a 25-gauge, 5/8-inch needle.…”

Section: Methodsmentioning

confidence: 99%

“…Among the few review articles on office-based anesthesia for oculofacial surgery, all are retrospective in nature and focus on local anesthesia techniques instead of validated oral sedation protocols. 1–7 To the authors knowledge, there have been no studies comparing office-based oral sedation to IV sedation or general anesthesia for oculofacial plastic surgeries. The goal of this study is to present a standardized oral sedation protocol and determine whether safety and patient experience are comparable between in-office and outpatient surgery center environments.…”

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confidence: 99%

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Oral Sedation Anesthesia Protocol for In-Office Oculoplastic Surgery

Conger,

Manipud,

Elhalouti

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To present an oral anesthesia protocol for in-office oculoplastic surgery and to compare safety outcomes and patient and physician experiences to ambulatory surgery center (ASC)-based surgery with intravenous sedation or general anesthesia. Methods: A prospective study was performed on consecutive patients undergoing surgery at an oculofacial plastic surgery practice. Surgery was performed in an in-office setting using our standardized oral sedation protocol or at an ASC with intravenous sedation or general anesthesia. Preoperative and postoperative surveys were conducted by patients and physicians to compare surgical experience, safety, and efficacy of our oral sedation protocol for in-office surgery in the ASC setting. Results: Two hundred and fifty-three patients (167 in-office and 86 at ASC) underwent surgery between March and November 2022. There was no significant difference in how patients or physicians rated their experience between the 2 locations. A significantly higher proportion of ASC patients would have rather had surgery in-office (34.9% vs. 19.2%; p = 0.006). A significantly higher number of physicians in the office setting would have rather performed surgery at the ASC than the reverse (12.7% vs. 2.3%, respectfully; p = 0.007). There were no safety complications reported in either setting. Conclusions: Within our patient cohort, the presented oral sedation protocol provided safe and effective anesthesia for in-office oculoplastic surgery that is comparable to an ASC.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Oral Sedation Anesthesia Protocol for In-Office Oculoplastic Surgery

Conger,

Manipud,

Elhalouti

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Although previous studies have found oral midazolam to be effective as premedication it is not widely available and has a higher cost than other benzodiazepines. Moreover, oral midazolam has been associated with some side effects such as respiratory depression and hypotension [9,14,15]. Among other benzodiazepines, alprazolam and triazolam have more rapid onset of action, shorter time to maximum blood concentration, and also a shorter duration of action than other benzodiazepines [16].…”

Section: Clinical Trial Registration: Nct01949038 Clinical-trialsgovmentioning

confidence: 99%

Premedication with sublingual or oral alprazolam in adults undergoing diagnostic upper gastrointestinal endoscopy

et al. 2014

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Background and study aim: Diagnostic esophagogastroduodenoscopy (EGD) is uncomfortable for most patients. We determined the efficacy of alprazolam, administered orally or sublingually, as premedication for sedation during EGD. Patients and methods: Adult EGD candidates were randomly allocated to four groups (n?=?55, each group) and received alprazolam (0.5?mg) sublingually or orally, placebo sublingually or orally at 30 minutes before EGD. Main outcome measures included procedure-related anxiety and pain/discomfort (assessed using 11-point numeric scales), patient overall tolerance (assessed using a 4-point Likert scale), need for intravenous sedation, and willingness to repeat the EGD if necessary. Results: Patients experienced greater reduction in anxiety score after medication with sublingual alprazolam (mean 2.25, standard deviation [SD] 1.73) compared with sublingual placebo (mean 0.10, standard error [SE] 0.15]; P?

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“…Moreover, there is a concern regarding hemodynamic side effects with its use. [ 9 14 15 ] Among other benzodiazepines, alprazolam has a relatively rapid onset and short duration of action and has been applied effectively for sedation before surgery,[ 16 17 ] and also for diagnostic EGD. [ 18 ] However, only a few head-to-head comparisons between benzodiazepines are conducted so far, most of them in children.…”

Section: Introductionmentioning

confidence: 99%

Premedication with benzodiazepines for upper gastrointestinal endoscopy: Comparison between oral midazolam and sublingual alprazolam

et al. 2017

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Background:Premedication with orally administered benzodiazepines is effective in reducing anxiety and discomfort related to endoscopic procedures. We evaluated the efficacy and safety of oral midazolam in comparison to sublingual alprazolam as premedication for esophagogastroduodenoscopy (EGD).Materials and Methods:Adult candidates for diagnostic EGD received either oral midazolam (7.5 mg in 15 cc apple juice) or sublingual alprazolam (0.5 mg) 30 min before EGD. Procedural anxiety and pain/discomfort were assessed using 11-point numerical rating scales. Patients’ overall tolerance (using a four-point Likert scale) and willingness to repeat the EGD, if necessary, were also assessed. Blood pressure, heart rate, and arterial oxygen saturation were monitored from medication to 30 min after the procedure.Results:Patients experienced a similar reduction in procedural anxiety after medication with oral midazolam and sublingual alprazolam; mean (standard deviation [SD] of 1.86 [1.63] and 2.02 [1.99] points, respectively, P = 0.91). Compared to oral midazolam, pain/discomfort scores were lower with sublingual alprazolam; mean (SD) of 4.80 (3.01) versus 3.68 (3.28), P = 0.024. There was no significant difference between the two groups in patients’ tolerance, willingness to repeat the procedure, or hemodynamic events.Conclusion:Oral midazolam and sublingual alprazolam are equally effective in reducing EGD-related anxiety; however, EGD-related pain/discomfort is lower with alprazolam. Both benzodiazepines are equally safe and can be used as premedication for patients undergoing diagnostic EGD.

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Oral Medication With Diazepam or Midazolam Associated or Not With Clonidine for Oculoplastic Office Surgery Under Local Anesthesia

Cited by 10 publications

References 27 publications

Oral Sedation Anesthesia Protocol for In-Office Oculoplastic Surgery

Oral Sedation Anesthesia Protocol for In-Office Oculoplastic Surgery

Premedication with sublingual or oral alprazolam in adults undergoing diagnostic upper gastrointestinal endoscopy

Premedication with benzodiazepines for upper gastrointestinal endoscopy: Comparison between oral midazolam and sublingual alprazolam

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