OPTIMIZED SCHEME OF DIAZEPAM USAGE DURING CORONARY ARTERY STENTING

Abstract

During invasive procedures in the X-ray operating room, sedation and analgesia have been used throughout its history. For sedation and anxiolytic effects, benzodiazepines, namely diazepam, were one of the drugs of choice. However, when using this drug, undesirable side effects have been identified, such as drowsiness, fatigue, amnesia, headache, tremors, cognitive impairments, and others.Objective. To establish the optimal scheme of analgosedation using diazepam for coronary artery stenting.Materials and research methods. The study included 60 patients with coronary artery disease who underwent a planned stenting of the coronary arteries. Analgosedation (AS) during stenting of the coronary arteries was performed routinely, and the patients were evenly divided into two study groups. The comparison group consisted of patients who underwent analgosedation based on diazepam and fentanyl. Patients in this group of AC were administered 10 mg of diazepam and 100 μg of fentanyl for induction, and repeated administration of drugs at the same dosage to maintain anesthesia during surgery. The study group consisted of patients with balanced usage of diazepam, namely, at the induction stage, we slowly intravenously injected 5 mg of diazepam solution and fentanyl solution at a dose of 1.5 mg / kg and 1.5 mg / kg / h to maintain the level analgesia. Intraoperatively, to maintain the level of sedation III on the RAMSEY scale (surface sedation), we used propofol solution.Conclusions. During the main stage, when sampling blood gases, we noted a difference in the level of oxygen, which was 6% higher in the study group (p = 0.044) and carbon dioxide, which was 11% higher (p = 0.018). This indicates the best rates of gas exchange in the balanced anesthesia group. During AS, based on the balanced usage of a combination of fentanyl and propofol solution, was better analgesic profile and fewer episodes of excessive sedation.