A large review found stronger evidence for some patient-reported outcomes than for others, so one certainty label cannot cover the entire result.
The systematic review assessed 123 randomized trials and pooled evidence separately for each patient-reported outcome. Moderate-certainty evidence suggested little or no effect on postoperative pain or quality of recovery. Satisfaction evidence was very uncertain. Twenty-two trials involving 2,165 participants suggested slightly higher postoperative anxiety, but certainty was low and heterogeneity substantial.
The review combined different benzodiazepines, timings, operations and comparators. The anxiety difference averaged 2.18 points on a twenty-to-eighty scale and should not be described without its size and uncertainty. Postoperative anxiety is not the same endpoint as anxiety immediately before induction. The synthesis also does not establish every effect in a chronically exposed patient.
When assessing a claimed benefit, identify the patient-reported outcome and when it was measured. Amnesia, clinician-rated calmness and patient satisfaction are not interchangeable. This review challenges a broad assumption that perioperative benzodiazepines necessarily improve the entire patient experience, while leaving room for specific indications and populations. It cannot establish an individual’s subjective experience or treatment preference from the average study result.
Source: PMC12799406, supplied full-text paper. Findings are paraphrased; forensic implications are an interpretation.
Related: A Better Early Anxiety Score Did Not Improve Every Pediatric Premedication Outcome.