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A prospective comparative study to examine the effects of oral diazepam on blood pressure and anxiety levels in patients with acute epistaxis.

Thong JF, Lo S, Houghton R, Moore-Gillon V

Department of Otorhinolaryngology - Head and Neck Surgery, Tan Tock Seng Hospital, Singapore.

Objective: To examine the effects of oral diazepam on blood pressure and anxiety in patients with acute epistaxis.Study design and setting: A prospective comparative study in an otorhinolaryngology tertiary referral centre.Participants: Patients with acute epistaxis requiring hospital admission.Intervention: Oral diazepam.Main outcome measures: Anxiety and blood pressure levels.Results: 32 patients received diazepam and 45 did not (control). On average, patients were hypertensive on admission (mean [standard deviation (SD)] systolic blood pressure diazepam group=157 mmHg [26], control=152 mmHg [23]; diastolic blood pressure diazepam group=87 mmHg [16], control=87 mmHg [18]). Both groups showed significant blood pressure reduction on discharge (p<0.0001) but the difference in mean blood pressure reduction between the two groups was insignificant (systolic blood pressure p=0.16, 95% confidence interval [CI]=-5 to +19 mmHg; diastolic blood pressure p=0.43, 95% CI=-8 to +10 mmHg). Anxiety was significantly lower on discharge (p<0.0001) but the difference in mean fall in anxiety scores between the two groups was insignificant (p=0.08, 95% CI=0 to +2). There was no significant correlation between total diazepam and changes in blood pressure (systolic blood pressure p=0.32; diastolic blood pressure p=0.65) or anxiety (p=0.73), nor between blood pressure and anxiety on admission (systolic blood pressure p=0.45; diastolic blood pressure p=0.72).Conclusions: Elevated blood pressure and anxiety in acute epistaxis patients reduced on epistaxis resolution irrespective of oral diazepam use. The elevated blood pressure does not appear to be directly related to anxiety.

Published 5 February 2007 in J Laryngol Otol, 121(2): 124-9.
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