Diazepam Premedication in Primary Augmentation Mammoplasty

Elizabeth A. Lucich, MD; Nicholas S. Adams, MD; Renee L. Barry, MD; Joshua J. Nelson, MD; Joshua P. Kelley, MD; John D. Renucci, MD


ePlasty. 2020;20(e2) 

In This Article


Following approval by the institutional review board, a retrospective review of 189 consecutive patients undergoing primary augmentation mammoplasty was conducted. All surgical procedures were performed at a single outpatient surgery center between July 2012 and July 2015 by 4 plastic surgeons and 13 anesthesiologists.

Patients undergoing surgery after December 30, 2014, were routinely administered preoperative oral diazepam. This group was compared with patients undergoing surgery before December 30, 2014, who did not receive anxiolytic premedication. Inclusion criterion included female patients 18 years or older undergoing bilateral primary augmentation mammoplasty. Patients undergoing revision augmentation mammoplasty or concurrent procedures in addition to primary augmentation mammoplasty were excluded, with the exception of minor superficial procedures including punch biopsy (n = 1), skin tag removal (n = 1), abdominal scar revision (n = 3), and nipple-areolar complex reduction (n = 3)

All augmentation mammoplasties were performed through an inframammary incision with implant placement in a subpectoral pocket. Local anesthetic was used routinely in all patients in the form of lidocaine and bupivacaine.

Data were collected from the chart including patient demographics, breast cup size, preoperative medications, operative technique, operative time, time to discharge, intraoperative medication use, postoperative pain and antiemetic medications, and early postoperative course. Opioid medications were converted to morphine-equivalents for a standardized evaluation.

Two-tailed t tests were used to compare data between the premedication group and the control group. A Pearson correlation was used to determine the relationship between results and implant size. Statistical significance was set at P < .05. Statistical analysis was conducted using SPSS software (SPSS Inc, Chicago, Ill).