Effects of oral diazepam on intravenous access in same day surgery patients

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Study Objective: To determine the effects of 5 mg oral diazepam on vein quality, patient anxiety, and intravenous (IV) access. Design: Prospective, randomized, double-blind, placebo controlled study. Setting: Preoperative holding area of a large university hospital. Patients: 202 adult ASA physical status I, II, and III patients scheduled for elective outpatient surgery. Interventions: Patients were randomized to receive either 5 mg oral diazepam or placebo, 30 minutes prior to IV access. Measurements and Main Results: Vein quality and patient anxiety were assessed prior to, and 30 minutes following, premedication (just prior to venipuncture) using a 5 point ordinal scale and 10 cm visual analog scale, respectively. The number of attempts at venous access and the gauge of the catheter used were also recorded. Baseline patient anxiety was similar between the two groups and both showed a significant improvement in patient anxiety at 30 minutes following drug administration. The diazepam group, however, had a significantly greater reduction in anxiety scores ( p < 0.05). There were no differences in baseline vein quality between the two groups; however, the quality of the vein was subjectively improved following diazepam administration. The mean number of attempts at IV access between the diazepam group (1.26 ± 0.56) and the placebo group (1.32 ± 0.65) was not significantly different. However, the ability to place larger gauge catheters was significantly enhanced in the diazepam group. Conclusions: The administration of 5 mg oral diazepam prior to the establishment of IV access improved vein quality and decreased patient anxiety. This technique may be a useful method for IV catheter placement, particularly when large gauge catheters are required, or when difficult IV access is anticipated.