[Hemodynamic and effects of preoperative sedation with the diazepam-droperidol combination]

Central venous or pulmonary arterial catheterisations under local analgesia before induction of anaesthesia may act as noxious stimuli likely to increase systemic arterial pressure and cardiac rate. This prospective study aimed to assess the value of an association of diazepam and droperidol for sedation, so as to prevent such haemodynamic disturbances. Fifty consecutive patients, 58 +/- 1.4 years old, most of them with severe cardiac disorders, were given an oral premedication which consisted of diazepam, 10 mg, with cimetidine, 200 mg, the previous evening, and diazepam (0.3 mg X kg-1) with cimetidine (400 mg) two hours before surgery. In the operation theatre, before central venous catheterisation, they received intravenous diazepam, 5 mg or 10 mg, according to their state of sedation at the time, and droperidol, 5 mg or 10 mg, according to systemic arterial pressure. In all cases, central venous catheterisation was performed under good conditions. Both systolic and diastolic pressures decreased by 11.65% and 10.10% respectively; cardiac rate was unchanged, while PaO2 decreased by 6.36% and PaCO2 increased by 4.97%. Severe transient hypoxaemia occurred in one 72-year old patient but without further clinical complication. Thus, this type of pre-operative sedation appears to be satisfactory, provided that the dose of i.v. diazepam does not exceed 5 mg in the elderly.