pre-procedural anxiety

Q: Alprazolam is not a good choice for pre-procedural anxiety because of its slower onset of action.

A) True

B) False

Answer: A

It is frequent for ICU patients to take trips to radiology or other procedural units as well as undergo procedures inside the ICU. 1-3 mg of Intravenous (IV) midazolam continues to be the drug of choice.

Oral alprazolam has shown mixed results but overall efficacy stayed inferior due to its slower onset of action as well as relatively short duration of effect. Sublingual (SL) alprazolam has been tried with success but data is very limited.

#procedures

References:

1. De Witte JL, Alegret C, Sessler DI, Cammu G. Preoperative alprazolam reduces anxiety in ambulatory surgery patients: a comparison with oral midazolam. Anesth Analg 2002; 95:1601.

2. Beydon L, Rouxel A, Camut N, et al. Sedative premedication before surgery--A multicentre randomized study versus placebo. Anaesth Crit Care Pain Med 2015; 34:165.

3. Shavakhi A, Soleiman S, Gholamrezaei A, et al. Premedication with sublingual or oral alprazolam in adults undergoing diagnostic upper gastrointestinal endoscopy. Endoscopy 2014; 46:633.