Canadian Journal of Anesthesia, Vol 17, 242-249, Copyright © 1970 by Canadian Anesthesiologists' Society

The Use of Intravenous Diazepam (Valium) as a Sedative and Relaxant in Urological Endoscopic Procedures

¹ Department of Anaesthesia, Sunnybrook Hospital, University of Toronto

Diazepam (Valium) has been studied as an intravenous adjunct to topical anaesthesia in urological endoscopic procedures and the following points have evolved:

1. No premedication or preoperative preparation is necessary.

2. There is a wide variation in response and tolerance to the drug.

3. Respiratory and cardiovascular depression are minimal and no resuscitative measures were needed, even with larger doses.

4. Larger doses tend to cause prolonged sedation, slow recovery, and more marked depression of blood pressure and respiration.

5. With intravenous diazepam the presence or absence of topical urethral anaesthesia seems not to make any significant difference.

6. Most patients much preferred diazepam to local anaesthesia alone, and expressed about equal preference for other forms of anaesthesia.

7. In certain difficult cases, especially those with marked urethral scarring and narrowing and bladder inflammation, the sedative and relaxant effects of diazepam are insufficient to provide comfort for the patient and ideal operating conditions for the surgeon. The addition of an intravenous narcotic or a light general anaesthetic is suggested in these cases.

8. Intravenous diazepam may be used in outpatients, but because of the wide variation in response to the drug, cases of prolonged sedation with dizziness and drowsiness will occur. A recovery area with full recovery room care, if necessary, should be available for these patients and they should have someone to take them home.

9. Complete absence of recall occurred in ten patients (14 per cent). Several of these had appeared to feel pain and had been given larger doses. (The average dose in amnesic patients was 13.2 mg, whereas the average for the series was 11 mg.)