Bromazepam vs. midazolam in blepharoplasty: A comparative analysis of perioperative anxiety

Abstract

Objectives. Invasive facial procedures can cause anxiety, discomfort and pain that nondrug methods and local anaesthetics might not fully relieve. To maintain periprocedural comfort and while avoiding systemic anaesthesia risks, noninvasive conscious sedation, using benzodiazepines like midazolam or bromazepam, can be used. The purpose of the research was to determine which premedication is most effective in blepharoplasty. Materials and methods. A retrospective study involved 85 female patients who underwent blepharoplasty at the Hospital of Lithuanian University of Health Sciences in 2023. The study participants did not exhibit any co-morbidities or harmful habits. The study groups comprised Group 1 (n=45), who received oral midazolam, and Group 2 (n=40), who administered oral bromazepam. Descriptive statistics included means (±) and median (Mdn) values (min-max). Statistical analyses employed the Mann-Whitney U and unpaired t-test. Results. No statistically significant differences were observed in demographic parameters between groups, with a mean age of 57.61 ± 8.154 and BMI of 26.58 ± 4.362. Patients in Group 1 reported significantly higher levels of preoperative anxiety (Mdn=4) compared to Group 2 (Mdn=2) (U=531, p=0.0069). However, there was no statistically significant difference between Group 1 (Mdn=2, (0–6)) and Group 2 (Mdn = 1, (0–4)) regarding anxiety during surgery (p=0.9785). Concerning postoperative anxiety, significantly more patients experienced it in Group 1 (Mdn=2, (0–6)) than in Group 2 (Mdn=0, (0–3)) (U=380, p<0.0001). The majority of participants in both Group 1 (63.64%) and Group 2 (58.33%) reported that “the surgical procedure exceeded their expectations” (p=0.6281). Conclusions. In comparison to midazolam, bromazepam demonstrates a superior reduction in both preoperative and postoperative anxiety. While there were no significant differences in anxiety during surgery, the overall findings suggest that bromazepam may be considered a more effective premedication option in blepharoplasty.