Impact of preoperative anxiolytic on surgical site infection in patients undergoing abdominal hysterectomy
published online 21 May 2008.
Background
An increased anxiety may be associated with a higher risk of surgical site infection (SSI), but there is little objective data on the effect of preoperative anxiolytic interventions on SSI. To address this issue, we evaluated the effects of preoperative diazepam on postoperative SSI following abdominal hysterectomy.
Methods
This randomized, double-blinded, placebo-controlled study included 130 patients, American Society of Anesthesiologist physical status 1 or 2. Patients were randomly assigned to receive either oral diazepam 10 mg (n = 65) or placebo (n =65) the night before and 1 hour prior to surgery. The assessment instruments were the Visual Analogue Scale and the State-Trait Anxiety Inventory. SSI was diagnosed according to the criteria of the Centers for Disease Control and Prevention with standard follow-up of 30 days.
Results
The relative risk (RR) was 1.79 (95% confidence interval [CI]: 1.31-2.43), and the number of patients that needed to be treated was 5.2 (95% CI: 2.74-50.76) to prevent 1 additional SSI. The RR for SSI in placebo-treated patients with high postoperative anxiety was 1.65 (95% CI: 1.07-2.56).
Conclusion
Diazepam-treated patients showed lower postoperative anxiety and lower incidence of SSI up to 30 days after surgery compared with placebo in patients undergoing abdominal hysterectomy.
aPostgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
bPharmacology Department, Instituto de Ciências Básicas da Saúde of UFRGS, Porto Alegre, Brazil
cDepartment of Psychiatry, School of Medicine, UFRGS, Porto Alegre, Brazil
dAnesthesia Service and Perioperative Medicine, Hospital de Clínicas de Porto Alegre (HCPA)/Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
Address correspondence to Wolnei Caumo, MD, PhD, Coronel Corte Real, 295 Bairro Petropolis CEP: 90630-008, Porto Alegre, RS, Brazil.
Supported by The Postgraduate Research Group (GPPG) at Hospital de Clínicas de Porto Alegre.
Conflicts of interest: There were no financial relationshipa between any of the authors or any commercial interest in the outcome of this study.
ABSTRACT