EFFECTS OF ROUTINE PREMEDICATION FOR CARDIAC-CATHETERIZATION ON SEDATION, LEVEL OF ANXIETY AND ARTERIAL OXYGEN-SATURATION

Objective: To assess the efficacy and side effects of routine premedic ation in patients undergoing cardiac catherization procedures in a ter tiary cardiac care institute. The criteria used included: arterial hem oglobin oxygen saturation (%SaO2), level of sedation and level of anxi ety before and after the procedure. Overall patient satisfaction was a lso quantified. Design: Sixty-two adult patients scheduled for cardiac catheterization procedures were recruited for the study. They were pr emedicated with one of several premedication regimens: oral diazepam 5 to 10 mg; oral lorazepam 1 mg; oral diazepam 10 mg + oral promethazin e 25 mg; or oral diazepam 10 mg + oral diphenhydramine 25 mg. No attem pt was made to control the premedication the patients received; it was ordered by each patient's cardiologist according to personal preferen ce. Patients underwent pulse oximetry and evaluation of sedation, anxi ety and level of satisfaction before and after cardiac catheterization . Results: All patients tested had values for mean precatherization %S aO2 above 92%. No patient had postcatheterization %SaO2 readings below that defined as indicating clinically significant hypoxemia (%SaO2 le ss than 90%). Patients were awake or lightly sedated before and after cardiac catheterization. Thirteen per cent of patients suffered from h igh levels of anxiety before, and 16% during, cardiac catheterization. Twenty-three per cent of patients reported being dissatisfied with th e premedication before, and 10% of patients reported being dissatisfie d during, cardiac catheterization. Conclusions: Clinically significant hypoxemia and oversedation are not problems for most patients given t he types and doses of precatheterization medication used in the study population. The premedication schedules followed in the study failed t o provide satisfaction and anxiolysis in a significant number of those studied.