Table 1 Characteristics of included studies
# | Study, year | Country | Study design | Enrolled participants, no. | Participant age, years | Types of sedations / Route of administration | Perioperative assessment of anxiety | Measure of anxiety |
|---|---|---|---|---|---|---|---|---|
1 | Dantas, 2017 [2] | Brazil | Crossover RCT | 40 | > 18 | -Passiflora incarnate 260 mg (OS) | Postop | DAS |
-Midazolam 15 mg (OS) | ||||||||
2 | Smiley, 2014 [12] | US | Parallel RCT | 24 | 18–32 | -Dexmedetomidine 1 μg/kg | Preop, postop | VAS |
+ Midazolam 0.03 mg/kg + Dexmedetomidine infusion 0.07 μg/k/hr. (IV) | ||||||||
-Dexmedetomidina 1 μg/kg + placebo + Dexmedetomidina infusion 0.07 μg/k/hr. (IV) | ||||||||
3 | Pereira Santos, 2013 [10] | Brazil | Crossover RCT | 32 | 18–29, with moderate or high anxiety | - N2O/O2 50% (INH) | Preop (DAS) | DAS, salivary cortisol |
-Midazolam 7.5 mg (OS) | Preop - postop (salivary cortisol) | |||||||
4 | Studer, 2012 [16] | Switzerland | Crossover RCT | 12 | 18–40 | -Midazolam 7.5 mg (OS) | Preop - Postop | VAS |
-Clonidine 150 μg (OS) | ||||||||
5 | Esen, 2005 [17] | Turkey | Crossover RCT | 20 | 18–26 | -Midazolam 0.05 mg/kg + PCI Remifentanil (20 μg initial bolus + 3 μg ・kg − 1 ・h − 1continuous infusion + 15 μg PCI, lockout 5 min, max 500 μg/h) (IV) | Preop, intraop, postop | Aldosterone, ACTH, renin |
-Midazolam 0.05 mg/kg + placebo (IV) | ||||||||
6 | Fong, 2005 [18] | China | Parallel RCT | 40 | > 18 | -Remifentanil 15–20 μg/ml PCI 1 ml bolus infused over 30 s, no further lockout (IV) | Postop | VAS |
-Placebo (IV) | ||||||||
7 | Ganzberg, 2005 [9] | US | Crossover RCT | 14 | 18–40 | -Zaleplon 10 mg (OS) | Preop, postop | VAS |
-Triazolam 0.5 mg (OS) | ||||||||
8 | Jerjes, 2005 [19] | UK | Parallel RCT | 46 | > 18 | -Midazolam 7.5 mg (OS) | Preop, intraop, postop | Salivary cortisol |
-Placebo (OS) | ||||||||
9 | Manani, 2004 [20] | Italy | Parallel RCT | 50 | N/A | -CDDZ 1 mg + midalozam 1 mg (OS+IV) | Postop | VAS, ISAR |
-CDDZ 1 mg + midalozam 2 mg (OS+IV) | ||||||||
10 | Leitch, 2004 [4] | UK | Parallel RCT | 110 | 17–49 | -Midazolam 2 mg + 1 mg per minute until patient-reported readiness (IV) | Preop, Intraop | VAS |
-Propofol 1% PMS – initial plasma concentration 1.5 μg/ml, then 1.0 μg/ml with patient controlled increments of 0.2 μg/ml lockout 2 min (IV) | ||||||||
11 | Dionne, 2001 [8] | US | Parallel RCT | 997 | N/A | -Midazolam until conscious sedation (mean dose 8.6 mg) (IV) | Intraop, postop | Scale 2–42 |
-Midazolam until conscious sedation + additional midazolam during surgery (mean total dose 12.2 mg) (IV) | ||||||||
-Fentanyl (1.4 μg/kg) + Midazolam until conscious sedation (mean dose 5.5 mg) (IV) | ||||||||
-Fentanyl (1.4 μg/kg) + Midazolam until conscious sedation (mean dose 5.8 mg) + additional Methohexital during surgery (mean dose 61.0 mg) (IV) | ||||||||
-Placebo (IV) | ||||||||
12 | Bell, 2000 [21] | UK | Parallel RCT | 60 | 19–55 | -Midazolam titrated in increments of 1 mg or 2 mg every 1 min (IV) + local anesthesia | Postop | DAS |
-Local anesthesia | ||||||||
13 | Milgrom, 1994 [22] | US | Parallel RCT | 207 | > 18 | -Midazolam titrated 1 mg per minute (IV) | Intraop, postop | Scale 0–42 |
-Midazolam titrated 1 mg per minute pre-surgery + Midazolam titrated 1 mg per minute during surgery up to 10 mg (IV) | ||||||||
-Fentanyl 0.014 mg/kg + Midazolam titrated 1 mg per minute (IV) | ||||||||
-Fentanyl 0.014 mg/kg + Midazolam titrated 1 mg per minute + methohexital 10 mg bolus + Methohexital follow up dose during surgery up to 200 mg (IV) | ||||||||
-Placebo (IV) | ||||||||
14 | Stopperich, 1993 [23] | US | Parallel RCT | 22 | 18–35 | -Triazolam 0.25 mg (OS) | Preop | VAS, ISAR |
-Placebo (OS) | ||||||||
15 | Luyk, 1992 [24] | New Zealand | Crossover RCT | 41 | 18–40 | -Midazolam 1 mg/min (IV) | Postop | VAS |
-Placebo (IV) | ||||||||
16 | Luyk, 1991 [25] | New Zealand | Crossover RCT | 33 | 18–32 | -Midazolam 7.5 mg (OS) + midazolam (IV) | Intraop | VAS |
-Placebo (OS) + midazolam (IV) | ||||||||
17 | O’Boyle, 1987 [26] | Ireland | Parallel RCT | 40 | N/A | -Midazolam 15 mg (OS) + placebo (IV) | Postop | VAS, STAI |
-Diazepam 10 mg (IV) + placebo (OS) |