Pro-Con Debate: Judicious Benzodiazepine Administration for Preoperative Anxiolysis in Older Patients

Abstract

In this Pro-Con commentary article, we discuss the risks and benefits of administering preoperative benzodiazepines to older patients to decrease preoperative anxiety. The Pro side first focuses on the critical importance of treating preoperative anxiety and that benzodiazepines are the best tool to achieve that goal. The competing argument presented by the Con side is that myriad options exist to treat preoperative anxiety without simultaneously increasing the risk for devastating complications such as postoperative delirium. Both sides call for more high-quality investigations to determine the most effective strategies for decreasing preoperative anxiety in older adults while improving outcomes and reducing morbidity.

Does Beers Put Preoperative Benzos on the Brink?

“…This issue’s “Pro-Con Debate: Judicious Benzodiazepine Administration for Preoper ative Anxiolysis in Older Patients” carefully examines the widespread practice of using benzodiazepines in the preoperative setting. 1 As Mahanna-Gabrielli et al 1 point out, anxiety left untreated has been associated with such untoward effects as increased postoperative pain and morbidity. 2,3 Benzodiazepines have proven to be effective management of anxiety and nausea, with patients receiving them overwhelmingly recommending this anxiolytic versus placebo.…”