Photo Credit: OlekStock
A study on patients undergoing Mohs surgery finds diazepam significantly reduces anxiety levels, gabapentin decreases early nervousness, and alprazolam shows a trend toward reduced nervousness.
The following is a summary of “Efficacy and Safety of Anxiolytics in Mohs Micrographic Surgery: A Randomized, Double-Blinded, Placebo-Controlled Trial,” published in the November 2023 issue of Dermatology by Guo, et al.
Anxiety can make surgery less successful by raising blood pressure, making it more necessary to treat pain after surgery, and making the patient less satisfied altogether. Even though calming drugs are used in outpatient treatments, there isn’t a lot of comparison proof on how well and safely they work in Mohs micrographic surgery.
For a study, researchers sought to find out how well and safely different anxiety-lowering drugs work before Mohs surgery to improve patient happiness and worry during the procedure. A double-blind, randomized, placebo-controlled study was done on 350 people who were going to have Mohs surgery and 6 different anxiety-lowering drugs (lorazepam, diazepam, alprazolam, gabapentin, pregabalin, and melatonin). Vital signs and anxiety levels were written down.
Compared to the dummy, diazepam showed a statistically significant and long-lasting decrease in anxiety levels (P =.03). Early nervousness went down a lot with gabapentin (P =.02). Soon after taking alprazolam, there was a trend towards less nervousness (P =.08). At any time point, lorazepam (P =.73), pregabalin (P =.53), and melatonin (P =.24) did not make patients less anxious compared to a sugar pill. Anxiolytics did not greatly affect any of the patients’ critical signs or mental abilities. Short-acting benzodiazepines and gamma-aminobutyric acid drugs may temporarily help with anxiety. Still, a single daily dose of 5 mg of diazepam can help with anxiety for a long time during Mohs surgery, and it is very safe for the patient.