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Record W4415601467 · doi:10.1016/j.bja.2025.09.013

Effects of perioperative benzodiazepine administration on postoperative patient-reported outcomes: a systematic review and meta-analysis of randomised controlled trials

2025· review· en· W4415601467 on OpenAlexafffund
Fang Zhou Ge, Karen Zhao, Emily Au, Behnam Sadeghirad, R. E. K. Fournier, Emilie P. Belley‐Côté, Jack Young, Eugene Wang, Chris Beaver, Shelley Kloppenburg, C. David Mazer, Eric Jacobsohn, Michael Verret, Jessica Spence

Bibliographic record

VenueBritish Journal of Anaesthesia · 2025
Typereview
Languageen
FieldPsychology
TopicSleep and related disorders
Canadian institutionsUniversity of ManitobaSt. Michael's HospitalUniversity of British ColumbiaUniversité LavalPopulation Health Research InstituteMcMaster UniversityUniversity of Toronto
FundersFonds de recherche du Québec – Nature et technologiesFonds de Recherche du Québec - SantéFonds de recherche du QuébecMcMaster UniversityHeart and Stroke Foundation of CanadaBayerAbbott Laboratories
KeywordsPerioperativeBenzodiazepineAdministration (probate law)Randomized controlled trialClinical trial

Abstract

fetched live from OpenAlex

<h2>Abstract</h2><h3>Background</h3> Benzodiazepines are administered during the perioperative period because they are believed to improve the patient experience. We conducted a systematic review and meta-analysis evaluating the effect of perioperative benzodiazepines on postoperative patient-reported outcomes. <h3>Methods</h3> We included randomised controlled trials of all languages comparing benzodiazepines with non-benzodiazepine comparators in adults undergoing inpatient surgery. Our outcomes were postoperative pain, quality of recovery, patient satisfaction, and anxiety. We assessed risk of bias using a modified Cochrane tool. We pooled data using a random-effects model and assessed the quality of evidence for each outcome using the Grading of Recommendations, Assessment, Development, and Evaluation approach. <h3>Results</h3> We screened 33 220 abstracts, 1156 full texts, and 123 RCTs, of which 93 were included in the quantitative synthesis. We identified moderate certainty evidence that benzodiazepines have no effect on patient-reported postoperative pain or quality of recovery and very low certainty evidence that benzodiazepines have no effect on patient satisfaction. We identified low certainty evidence that benzodiazepines result in higher levels of postoperative anxiety (22 trials, <i>n</i>=2165; mean difference, 2.18 points on the 20–80 State-Trait Anxiety Inventory Scale; 95% confidence interval, 1.05–3.30; <i>I</i><sup>2</sup>=90%). <h3>Conclusions</h3> Benzodiazepine administration in the perioperative period probably has no effect on postoperative pain or quality of recovery and has an uncertain effect on patient satisfaction (very low certainty evidence). When compared with placebo or another agent, benzodiazepines might result in higher levels of postoperative anxiety. Definitive research is required to determine whether the balance of risks and benefits justifies using benzodiazepines during the perioperative period to improve patient-reported outcomes. <h3>Systematic review protocol</h3> PROSPERO (CRD42023440326).

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.005
metaresearch head score (Gemma)0.013
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Meta-epidemiology (narrow), Meta-epidemiology (broad)
Consensus categoriesMeta-epidemiology (broad)
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Meta-analysis · Consensus signal: Meta-analysis
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.097
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0050.013
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0380.011
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.041
GPT teacher head0.365
Teacher spread0.324 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; both teacher heads agree on what is shown here.

Study designMeta-analysis
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations5
Published2025
Admission routes2
Has abstractyes

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