In dermatological cases, Oral benzodiazepines safe and effective for periprocedural anxiolysis

USA: A new study conducted by Michelle A. Boettler and the team found that the use of oral benzodiazepines (BZDs) in periprocedural anxiolysis appears to be safe and effective in the short term. The findings of this study were published in the journal Dermatologic Surgery.

The researchers suggest, "the 2020 FDA black-box warning should not dissuade their appropriate use in dermatologic surgery and other low-risk outpatient procedures." 

Barbiturates have a poor therapeutic index, so BZDs were popular in our nation and across the world for a variety of diseases several decades ago one of them is they are effective against periprocedural anxiolytic agents. The Food and Drug Administration (FDA) of the United States recently issued a black-box warning about the hazards of misuse and dependency.

Against the above backdrop, researchers conducted a systematic review to assess the safety and efficacy of oral BZDs for periprocedural anxiolysis in outpatient plastic surgery, dermatologic, ophthalmologic, and dental procedures done under local anesthetics. Despite the FDA's black box warning for benzodiazepines, no research investigated dependence or addiction.

A systematic evaluation of five databases was conducted in accordance with the criteria for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data on the safety and effectiveness of oral benzodiazepines were taken from relevant journals.

The results of this study stated as follow:

1. There were 43 articles and 4,060 topics in all.

2. In most investigations, oral BZDs consistently had a good anxiolytic effect and displayed superior or comparable ratings in surgeon satisfaction, patient satisfaction, pain, and anxiety to comparison groups.

3. Thirty-five patients had temporary hypoxia, while two had transient hypertension.

4. There were 195 reports of minor, self-limiting side effects. In this therapeutic environment, none of the research addressed the hazards of misuse and dependency.

5. Adverse effects were recorded seldom, with just a few examples of transitory hypertension and hypoxia response to tactile stimulation or supplementary oxygen being documented.

In conclusion, the findings of this study points towards the fact that in dermatological practice, periprocedural oral benzodiazepines appear to deliver anxiolysis safely.

Reference:

Boettler, M. A., Shahwan, K. T., Cusick, A., Avila, C., & Carr, D. R. (2022). Safety and Efficacy of Oral Benzodiazepines for Periprocedural Anxiolysis. In Dermatologic Surgery: Vol. Publish Ahead of Print. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/dss.0000000000003407

Keywords: Hypertension, hypoxia, dermatology, benzodiazepines, tactile stimulation oxygen, anxiolysis, sedation, dermatologic surgery,