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Conscious Sedation and Analgesia for Routine Aortofemoral Arteriography: A Prospective Evaluation¹

¹ From the Department of Radiology, the Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland (P.T.K., I.M.G.K., W.C.L., C.S.B.), and the Belfast City Hospital, Northern Ireland (P.T.K., W.C.L.). From the 1998 RSNA scientific assembly. Received June 14, 1999; revision requested August 3; revision received December 16; accepted January 12, 2000. Address correspondence to P.T.K. (e-mail: ptkennedy@classicfm.net).

PURPOSE: To compare the effectiveness of temazepam and midazolam hydrochloride with or without fentanyl citrate versus a placebo in promoting patient acceptance of diagnostic aortofemoral arteriography.

MATERIALS AND METHODS: One hundred twenty-five patients undergoing aortofemoral arteriography were prospectively and randomly assigned to one of four treatment arms: placebo (group A), oral temazepam (group B), intravenous midazolam (group C), or intravenous midazolam and fentanyl (group D). Patients were blinded to the administered sedative. Five-point scales were used to assess degree of patient discomfort, willingness to undergo the same procedure again, patient compliance, and preprocedural anxiety.

RESULTS: There was no difference between patient groups in willingness to return for a repeat procedure (P = .89). Group C patients were less compliant during the procedure (P = .034). Mean patient discomfort scores were 1.81 for group A , 1.84 for group B, 1.53 for group C, and 1.27 for group D. Discomfort experienced during the procedure was not related to the degree of preprocedural anxiety (P = .42). Patients who had previously undergone arteriography reported a higher level of pain than did those who had not (P = .021).

CONCLUSION: Most patients experienced only low-level discomfort during diagnostic aortofemoral arteriography. In the authors’ opinion, conscious sedation should only be used selectively, not routinely, for diagnostic aortofemoral arteriography.

Index terms: Anesthesia, 92.64 • Angiography, 92.122 • Arteries, extremities • Arteries, stenosis or obstruction, 92.721 • Arteriosclerosis, 92.721 • Drugs, 92.64

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