The Efficacy and Safety of Diazepam for Intraoperative Blood Pressure Stabilization in Hypertensive Patients Undergoing Vitrectomy Under Nerve Block Anesthesia: A Prospective, Single-Center, Double-Blind, Randomized, Controlled Trial
Tianwei Qian,1– 5,* Qiaoyun Gong,1– 5,* Yiyang Shu,1– 5 Hangqi Shen,1– 5 Xia Wu,1– 5 Weijun Wang,1– 5 Zhihua Zhang,1– 5 Hui Cao,1– 5 Xun Xu1– 5 1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 2National Clin...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Dove Medical Press
2024-01-01
|
Series: | Therapeutics and Clinical Risk Management |
Subjects: | |
Online Access: | https://www.dovepress.com/the-efficacy-and-safety-of-diazepam-for-intraoperative-blood-pressure--peer-reviewed-fulltext-article-TCRM |
_version_ | 1797355348059750400 |
---|---|
author | Qian T Gong Q Shu Y Shen H Wu X Wang W Zhang Z Cao H Xu X |
author_facet | Qian T Gong Q Shu Y Shen H Wu X Wang W Zhang Z Cao H Xu X |
author_sort | Qian T |
collection | DOAJ |
description | Tianwei Qian,1– 5,* Qiaoyun Gong,1– 5,* Yiyang Shu,1– 5 Hangqi Shen,1– 5 Xia Wu,1– 5 Weijun Wang,1– 5 Zhihua Zhang,1– 5 Hui Cao,1– 5 Xun Xu1– 5 1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 2National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China; 3Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, People’s Republic of China; 4Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People’s Republic of China; 5Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hui Cao; Zhihua Zhang, Tel +86 (0) 13611878111 ; +86 (0) 13817901235, Fax +86 021-63240090, Email drcaohui@126.com; drzhihuazhang@126.comPurpose: To evaluate the effectiveness and safety of diazepam in maintaining stable intraoperative blood pressure (BP) in hypertensive patients undergoing vitrectomy under nerve block anesthesia.Methods: A total of 180 hypertensive patients undergoing vitrectomy with nerve block anesthesia were randomized into two groups. The intervention group was given oral diazepam 60 min before operation, while the control group was given oral placebo 60 min before operation. The primary outcome is the effective rate of intraoperative BP control, defined as systolic blood pressure (SBP) during the operation maintained < 160 mmHg at all timepoints. The logistic regression model will be performed to analyze the compare risk factors for ineffective BP control.Results: The effective rate of intraoperative SBP control in the diazepam group was significant higher than that in the placebo group from 15 min to 70 min of the surgery (P < 0.05). The proportion of patients with SBP ≥ 180 mmHg at any timepoint from operation to 1 h postoperation was higher in the placebo group (12.22%) than in the diazepam group (2.22%) (P = 0.0096). We observed that the change in SBP from baseline consistently remained higher in the placebo group than in the diazepam group. In the logistic regression analysis, age, years of diagnosed hypertension and SBP 1h before surgery were significant risk factors for ineffective BP control.Conclusion: This study provides robust evidence supporting the effectiveness of oral diazepam as a pre-surgery intervention in maintaining stable blood pressure during vitrectomy in hypertensive patients.Trial Registration: Chinese Clinical Trial Registry (ChiCTR), ChiCTR2100041772.Keywords: nerve block anesthesia, vitrectomy, diazepam, blood pressure stabilization |
first_indexed | 2024-03-08T14:09:49Z |
format | Article |
id | doaj.art-5164e7abd4104bc38236f91b331122ac |
institution | Directory Open Access Journal |
issn | 1178-203X |
language | English |
last_indexed | 2024-03-08T14:09:49Z |
publishDate | 2024-01-01 |
publisher | Dove Medical Press |
record_format | Article |
series | Therapeutics and Clinical Risk Management |
spelling | doaj.art-5164e7abd4104bc38236f91b331122ac2024-01-14T18:47:16ZengDove Medical PressTherapeutics and Clinical Risk Management1178-203X2024-01-01Volume 2091889670The Efficacy and Safety of Diazepam for Intraoperative Blood Pressure Stabilization in Hypertensive Patients Undergoing Vitrectomy Under Nerve Block Anesthesia: A Prospective, Single-Center, Double-Blind, Randomized, Controlled TrialQian TGong QShu YShen HWu XWang WZhang ZCao HXu XTianwei Qian,1– 5,* Qiaoyun Gong,1– 5,* Yiyang Shu,1– 5 Hangqi Shen,1– 5 Xia Wu,1– 5 Weijun Wang,1– 5 Zhihua Zhang,1– 5 Hui Cao,1– 5 Xun Xu1– 5 1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 2National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China; 3Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, People’s Republic of China; 4Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People’s Republic of China; 5Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hui Cao; Zhihua Zhang, Tel +86 (0) 13611878111 ; +86 (0) 13817901235, Fax +86 021-63240090, Email drcaohui@126.com; drzhihuazhang@126.comPurpose: To evaluate the effectiveness and safety of diazepam in maintaining stable intraoperative blood pressure (BP) in hypertensive patients undergoing vitrectomy under nerve block anesthesia.Methods: A total of 180 hypertensive patients undergoing vitrectomy with nerve block anesthesia were randomized into two groups. The intervention group was given oral diazepam 60 min before operation, while the control group was given oral placebo 60 min before operation. The primary outcome is the effective rate of intraoperative BP control, defined as systolic blood pressure (SBP) during the operation maintained < 160 mmHg at all timepoints. The logistic regression model will be performed to analyze the compare risk factors for ineffective BP control.Results: The effective rate of intraoperative SBP control in the diazepam group was significant higher than that in the placebo group from 15 min to 70 min of the surgery (P < 0.05). The proportion of patients with SBP ≥ 180 mmHg at any timepoint from operation to 1 h postoperation was higher in the placebo group (12.22%) than in the diazepam group (2.22%) (P = 0.0096). We observed that the change in SBP from baseline consistently remained higher in the placebo group than in the diazepam group. In the logistic regression analysis, age, years of diagnosed hypertension and SBP 1h before surgery were significant risk factors for ineffective BP control.Conclusion: This study provides robust evidence supporting the effectiveness of oral diazepam as a pre-surgery intervention in maintaining stable blood pressure during vitrectomy in hypertensive patients.Trial Registration: Chinese Clinical Trial Registry (ChiCTR), ChiCTR2100041772.Keywords: nerve block anesthesia, vitrectomy, diazepam, blood pressure stabilizationhttps://www.dovepress.com/the-efficacy-and-safety-of-diazepam-for-intraoperative-blood-pressure--peer-reviewed-fulltext-article-TCRMnerve block anesthesiavitrectomydiazepamblood pressure stabilization |
spellingShingle | Qian T Gong Q Shu Y Shen H Wu X Wang W Zhang Z Cao H Xu X The Efficacy and Safety of Diazepam for Intraoperative Blood Pressure Stabilization in Hypertensive Patients Undergoing Vitrectomy Under Nerve Block Anesthesia: A Prospective, Single-Center, Double-Blind, Randomized, Controlled Trial Therapeutics and Clinical Risk Management nerve block anesthesia vitrectomy diazepam blood pressure stabilization |
title | The Efficacy and Safety of Diazepam for Intraoperative Blood Pressure Stabilization in Hypertensive Patients Undergoing Vitrectomy Under Nerve Block Anesthesia: A Prospective, Single-Center, Double-Blind, Randomized, Controlled Trial |
title_full | The Efficacy and Safety of Diazepam for Intraoperative Blood Pressure Stabilization in Hypertensive Patients Undergoing Vitrectomy Under Nerve Block Anesthesia: A Prospective, Single-Center, Double-Blind, Randomized, Controlled Trial |
title_fullStr | The Efficacy and Safety of Diazepam for Intraoperative Blood Pressure Stabilization in Hypertensive Patients Undergoing Vitrectomy Under Nerve Block Anesthesia: A Prospective, Single-Center, Double-Blind, Randomized, Controlled Trial |
title_full_unstemmed | The Efficacy and Safety of Diazepam for Intraoperative Blood Pressure Stabilization in Hypertensive Patients Undergoing Vitrectomy Under Nerve Block Anesthesia: A Prospective, Single-Center, Double-Blind, Randomized, Controlled Trial |
title_short | The Efficacy and Safety of Diazepam for Intraoperative Blood Pressure Stabilization in Hypertensive Patients Undergoing Vitrectomy Under Nerve Block Anesthesia: A Prospective, Single-Center, Double-Blind, Randomized, Controlled Trial |
title_sort | efficacy and safety of diazepam for intraoperative blood pressure stabilization in hypertensive patients undergoing vitrectomy under nerve block anesthesia a prospective single center double blind randomized controlled trial |
topic | nerve block anesthesia vitrectomy diazepam blood pressure stabilization |
url | https://www.dovepress.com/the-efficacy-and-safety-of-diazepam-for-intraoperative-blood-pressure--peer-reviewed-fulltext-article-TCRM |
work_keys_str_mv | AT qiant theefficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT gongq theefficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT shuy theefficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT shenh theefficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT wux theefficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT wangw theefficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT zhangz theefficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT caoh theefficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT xux theefficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT qiant efficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT gongq efficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT shuy efficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT shenh efficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT wux efficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT wangw efficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT zhangz efficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT caoh efficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial AT xux efficacyandsafetyofdiazepamforintraoperativebloodpressurestabilizationinhypertensivepatientsundergoingvitrectomyundernerveblockanesthesiaaprospectivesinglecenterdoubleblindrandomizedcontrolledtrial |