Saline flush: a simple method of reducing diazepam-induced thrombophlebitis

Area of Science:

• Medical research
• Clinical trials
• Gastroenterology

Background:

• Intravenous diazepam is commonly used for sedation during endoscopic procedures.
• Thrombophlebitis, an inflammation of a vein with a clot, can occur after intravenous drug administration.
• Minimizing side effects like pain and thrombophlebitis is crucial for patient comfort and procedural success.

Purpose of the Study:

• To compare the incidence of thrombophlebitis after intravenous diazepam administration.
• To evaluate the efficacy of a saline flush versus 'barbotage' in reducing diazepam-induced side effects.
• To determine the optimal method for administering intravenous diazepam during endoscopy.

Main Methods:

• A controlled trial involving 500 outpatients undergoing endoscopy.
• Comparison of three administration methods: intravenous diazepam alone, diazepam with saline flush, and diazepam with 'barbotage' (dilution with patient's blood).
• Patient-reported outcomes assessed via questionnaire two weeks post-endoscopy, with an 80% response rate.

Main Results:

• A saline flush significantly reduced the incidence of side effects, particularly pain (P < 0.05).
• 'Barbotage' resulted in the highest incidence of adverse effects.
• The saline flush group experienced fewer complications compared to other methods.

Conclusions:

• Saline flush is recommended to mitigate thrombophlebitis and associated pain following intravenous diazepam.
• Barbotage is associated with an increased risk of side effects.
• Optimizing diazepam administration enhances patient safety and procedural tolerance during endoscopy.