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September 10, 1973

Thrombophlebitis Following Diazepam

Author Affiliations

USAF Lackland AFB, Tex

JAMA. 1973;225(11):1389. doi:10.1001/jama.1973.03220390063027

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To the Editor.—  In our article, "Thrombophlebitis With Diazepam Used Intravenously" (223:184, 1973), we alluded to preliminary results of a controlled study using various flush media. The flush material was used in a double-blind manner except for the volume given. The results in 1,089 patients are shown in the Table.All cases not indicative of thrombophlebitis with a segment of 2 cm or more were included. The majority were of minor impact, but some were protracted and involved long vein segments. There was no statistical difference between the additives. As can be seen, volumes of 150 to 250 ml of saline were beneficial. Amnesia and rapidity of action are the prime advantages of diazepam by intravenous rather than intramuscular routes for endoscopy.In our endoscopy clinic during the past seven years, protracted long-segment phlebitis remains the only major complication of fiberoptic endoscopy. We still think diazepam is a premedication of