Abstract：
Patient anxiety can complicate surgical outcomes by elevating blood pressure, increasing the need for postoperative pain management, and reducing overall patient satisfaction. Despite the use of anxiolytic medications in outpatient procedures, there is limited comparative evidence on the efficacy and safety of these agents in Mohs micrographic surgery.
To compare the effectiveness and safety of different preprocedural anxiolytic agents in Mohs surgery on perioperative patient anxiety and patient satisfaction.
A double-blinded, randomized, placebo-controlled trial was conducted of 6 different preprocedural anxiolytic agents (lorazepam, diazepam, alprazolam, gabapentin, pregabalin, and melatonin) in 350 patients undergoing Mohs surgery. Anxiety and vital signs were recorded.
Diazepam demonstrated a statistically significant, sustained reduction in anxiety levels compared with placebo ( p = .03). Gabapentin significantly reduced early anxiety ( p = .02). Alprazolam showed a trend to early anxiety reduction ( p = .08). Lorazepam ( p = .73), pregabalin ( p = .53), and melatonin ( p = .24) failed to reduce patient anxiety compared with placebo at any time point. No anxiolytic significantly impacted any patient vital sign or cognition.
Although short-acting benzodiazepines and gamma-aminobutyric acid medications may have transient anxiolytic effects, a single oral dose of 5 mg of diazepam can provide a sustained anxiolytic effect in Mohs surgery, with excellent patient safety.
To compare the effectiveness and safety of different preprocedural anxiolytic agents in Mohs surgery on perioperative patient anxiety and patient satisfaction.
A double-blinded, randomized, placebo-controlled trial was conducted of 6 different preprocedural anxiolytic agents (lorazepam, diazepam, alprazolam, gabapentin, pregabalin, and melatonin) in 350 patients undergoing Mohs surgery. Anxiety and vital signs were recorded.
Diazepam demonstrated a statistically significant, sustained reduction in anxiety levels compared with placebo ( p = .03). Gabapentin significantly reduced early anxiety ( p = .02). Alprazolam showed a trend to early anxiety reduction ( p = .08). Lorazepam ( p = .73), pregabalin ( p = .53), and melatonin ( p = .24) failed to reduce patient anxiety compared with placebo at any time point. No anxiolytic significantly impacted any patient vital sign or cognition.
Although short-acting benzodiazepines and gamma-aminobutyric acid medications may have transient anxiolytic effects, a single oral dose of 5 mg of diazepam can provide a sustained anxiolytic effect in Mohs surgery, with excellent patient safety.
摘要：
背景：患者的焦虑可以通过升高血压使手术结果复杂化，增加了对术后疼痛管理的需求，降低患者总体满意度。尽管在门诊手术中使用抗焦虑药物，关于这些药物在Mohs显微手术中的疗效和安全性的比较证据有限.
目的：比较不同术前抗焦虑药在Mohs手术围手术期患者焦虑和患者满意度的有效性和安全性。
方法：双盲，随机化，安慰剂对照试验是对6种不同的术前抗焦虑药(劳拉西泮，地西泮,阿普唑仑,加巴喷丁,普瑞巴林,和褪黑激素）在350名接受Mohs手术的患者中。记录焦虑和生命体征。
结果：地西泮具有统计学意义，与安慰剂相比，焦虑水平持续降低(p=0.03)。加巴喷丁显著降低早期焦虑(p=.02)。阿普唑仑显示出早期焦虑减轻的趋势(p=.08)。劳拉西泮（p=.73），普瑞巴林（p=.53），与安慰剂相比，褪黑素（p=0.24）在任何时间点都无法减轻患者的焦虑。没有抗焦虑药显着影响任何患者的生命体征或认知。
结论：尽管短效苯二氮卓类药物和γ-氨基丁酸药物可能具有短暂的抗焦虑作用，单次口服5毫克地西泮可以在Mohs手术中提供持续的抗焦虑作用，具有出色的患者安全性。
目的：比较不同术前抗焦虑药在Mohs手术围手术期患者焦虑和患者满意度的有效性和安全性。
方法：双盲，随机化，安慰剂对照试验是对6种不同的术前抗焦虑药(劳拉西泮，地西泮,阿普唑仑,加巴喷丁,普瑞巴林,和褪黑激素）在350名接受Mohs手术的患者中。记录焦虑和生命体征。
结果：地西泮具有统计学意义，与安慰剂相比，焦虑水平持续降低(p=0.03)。加巴喷丁显著降低早期焦虑(p=.02)。阿普唑仑显示出早期焦虑减轻的趋势(p=.08)。劳拉西泮（p=.73），普瑞巴林（p=.53），与安慰剂相比，褪黑素（p=0.24）在任何时间点都无法减轻患者的焦虑。没有抗焦虑药显着影响任何患者的生命体征或认知。
结论：尽管短效苯二氮卓类药物和γ-氨基丁酸药物可能具有短暂的抗焦虑作用，单次口服5毫克地西泮可以在Mohs手术中提供持续的抗焦虑作用，具有出色的患者安全性。
