The benefits of reducing anxiety in a Podiatric Surgical Unit in the UK with Midazolam

Abstract

Sedation has been frequently used alongside many surgical interventions under local anaesthetics (LA). In podiatric surgery, there is a paucity of literature on the effects of sedation drugs on surrogate measures of patients’ physiological signs. General anaesthetic is practised more frequently than sedation assisted local anaesthetic in podiatry. The aim of this audit was to analyse blood pressure (BP) and heart rate (HR) against the administration of midazolam. A retrospective assessment of sedation notes prior to podiatric procedures undertaken during the years 2008/2009 was performed. BP (systolic/diastolic mm Hg) and heart rate (beats/min) were recorded prior to the administration of midazolam and for the first 30 minutes following administration. Ninety-four consecutive patients (74 women, 20 men) were admitted for podiatric surgery. Ninety-nine interventions were performed, with five of the subjects undergoing two procedures. The mean age was 59±13.5 years (21-87) and average midazolam administered 2.8±1.3 mg (0.5-8). Average BP prior to midazolam was 148/85 mm Hg and HR 80. At 30 minutes assessment BP was 136/80 and HR 71. BP and HR differences were significantly different at p<0.001 to the reading prior to administration. The results presented indicate the use of such a drug as an adjunct to LA in a sedation context has favourable results.