Do We Need Premedication Before Coronary Angiography? A Controlled Clinical Trial

Area of Science:

• Cardiology
• Pharmacology

Background:

• Benzodiazepine premedication is traditionally used to manage anxiety and pain during cardiac procedures.
• The efficacy of routine premedication with diazepam and chlorpheniramine before coronary angiography is not well-established.

Purpose of the Study:

• To evaluate the necessity of routine premedication with diazepam and chlorpheniramine for coronary angiography.
• To assess the impact of premedication on patient anxiety and pain perception during cardiac catheterization.

Main Methods:

• A randomized controlled trial involving 200 patients undergoing coronary angiography.
• Patients were assigned to receive either premedication (diazepam 5 mg and chlorpheniramine 4 mg) or no premedication 60 minutes prior to the procedure.
• Primary endpoints included anxiety and pain perception, with midazolam administered intravenously at the operator's discretion.

Main Results:

• No significant difference in overall anxiety rates between the premedicated (59%) and non-premedicated (50%) groups (P = 0.2).
• No significant difference in periprocedural pain perception between the groups (31% vs. 29%, P = 0.75).
• Local pain was reported more frequently in the premedicated group (30%) compared to the non-premedicated group (16%) (P = 0.018).

Conclusions:

• Routine premedication with oral diazepam and chlorpheniramine does not improve anxiety or pain outcomes in patients undergoing cardiac catheterization.
• The findings suggest that this premedication strategy is not necessary and may potentially increase local discomfort.