ISSN: 1812–1217
Al – Rafidain Dent J
Vol. 12, No2, 2012
322
successful completion of the procedure and potentially minimize risk to the patient.
There are a variety of sedatives available. Most of the standard and most popular sedatives have been in existence for almost 100 years. (4)
The pediatric dental literature contains numerous reports on various medications
(e.g., nitrous oxide, opioids, benzodiazepines, chloral hydrate, barbiturates and antihistamines) which have been administrated alone or in combination. (5 – 9)
Diazepam has been used to manage an uncooperative child in a dental setting.
It is a water insoluble benzodiazepine and requires the organic solvent propylene glycol to dissolve it. Propylene glycol is most likely responsible for renoirritation and thrombophebitis that may occur during injection. Diazepam undergoes metabolism to active desmethyl diazepam and oxazepam that can produce sedation 6 – 8 hours after its initial administration (10).
Diazepam is sedative – hypnotic agent and act in the brain on specific receptors enhancing
GABAergic transmission. Flumazenil can be used to reverse the sedative action of diazepam but repeated doses are needed (11). Diazepam is very popular sedating agents due to its wide margin of safety and it has wide therapeutic index. It has many pharmacological effects which include: sedation, hypnosis, anesthesia, anticonvulsant effects, muscle relaxation and effects on respiration and cardiovascular function. It is indicated
Ketamine can be used for sedation before minor procedures, although this use is not approved by the FDA
Flumazenil is the drug that is used to treat benzodiazepine overdose. In adults the dosage is 0.2 mg, additional 0.3 mg may be given 30 sec later. Further doses of 0.5 mg may be given at 1-min intervals, if necessary to a total dose of 3 mg. In children, 0.01 mg/kg (maximum dose 0.2 mg) with repeat doses every minute up to a cumulative dose of 1 mg. Seizures are a life threatening risk associated with Flumazenil.
Oral sedatives are pills taken by mouth or dissolved under the tongue about an hour before the procedure. Most patients feel sleepiness and heaviness in their limbs after taking the medication. You are conscious throughout the procedure, however. If you do fall asleep, Dr. Das can easily wake you. Oral sedation is a popular option for patients who hate needles.
Several analysis and statistics have been done on Fentanyl. The PLOS ONE did an analysis, their goal was to establish the effect Fentanyl had on children with the presence of emergence agitation (EA) under sevoflurane anesthesia. In all 16 studies were done which included 1362 patients, 737patients were for the Fentanyl group and the rest were for the placebo group, which is an ineffectual treatment for a medical condition. With the presence of Fentanyl, the incidence of EA as well as pain was decreased. However, it increased the frequency of nausea and vomiting denoting the period following the surgical operation. The study concluded that Fentanyl may be associated with a decreased incidence of EA in children and was proven to have a higher
Sedation dentistry, which may be administered via oral pill, nitrous oxide (laughing gas), or through an IV, is designed to help patients relax prior to and during a dental procedure. Often times, patients don't remember much, if anything, about the procedure following sedation. It should be noted that sedation dentistry may be referred to as sleep dentistry, however, patients remain aware and cooperative throughout
The adrenaline consumes the soul resulting in determined focus whether pulling the trigger hunting or cutting the first precision in an intricate surgery. Hunting started as a necessary part one lives until it eventually led to a sport that captivates a large portion of the world. Not a single germ could survive in the most sterile environment known to man, the operating room. Each advancement made to the surgical field allows surgeons quicker operations and speedier recoveries for patients. Although one saves others lives as another puts one to the end, hunting and a surgical procedure reflect the same principles of preparation, the execution, the follow up, and the change.
The main difference between the two cocktails lies in the fact that Midazolam was never meant to put a person to sleep as an anesthetic by itself. Anesthetics not only put people to sleep, but they also maintain the sleep state by promoting different combinations of drugs in the brain to synthesize and spread throughout the body. Meanwhile, Midazolam is only used to put someone to sleep, not to keep someone asleep, and it is definitely not meant for any extended period of
Since the type of medication typically given as a calming agent is a benzodiazapine, make sure to alert your dentist if you have taken a medication of that class in the past and had a reaction called a paradoxical reaction. While somewhat rare, you would know if you experienced it in the past when taking a benzodiazapine if the medication actually made you more alert instead of relaxing you. If suspected that you may have this type of reaction again, your dentist may opt to prescribe a different type of sedative less likely to cause this reaction
The positive impact of anesthesia advancements over the last 100 years have made the care that patient receives more effective and less life threatening. These innovations have brought about a transformation in the care of the patient. It has improved how the healthcare institutions operate and the patient has benefited from the advancements and so have the medical staff. The anesthesia used today, and the anesthesia used a century ago is similar because it was created for the welfare of the patient. It was produced to help numb or put the patient to sleep during a surgical procedure. However, the difference today is that research and advancements in the medical field have improved and designed more superior drugs over the years and made them
Clonazepam is considered a Benzodiazepine and is generally used to treat patients who have petit-mal, akinetic, and myoclonic seizures, or those with panic disorder (Wynn, Meiller, & Crossley, 2014). Benzodiazepines take action by binding to receptors on gamma-aminobutyric acid (GABA) and increase membrane permeability to chloride
Dental care and treatment is a very important aspect in a person's life. Every individual wants a beautiful smile and so it comes without saying that you will need a dentist for certain procedures to be done. Fear and anxiety ,however, can prevent someone from paying the dentist a visit. These fears can be eliminated by a technique referred to as sedation dentistry. Certain sedation drugs in pill, intravenous or gas form are given to patients to help them to relax. Some dentists also use anxiety-relieving approches like music to put the patient in a relaxed mood. Below are four advantages of the sedation dentistry technique:
Sedation dentistry uses various types of medication to help you relax and feel calm during dental procedures. The type and level of dental sedation is variable and is chosen based on your personal needs and the complexity of your procedure. Conscious sedation dentistry allows you to remain awake and responsive. It may involve medications that are given orally or through an IV. An anesthesia dentist also has the option of administering nitrous oxide gas (N2O), which is an effective and
Sedation has become more common-place for pediatric patients undergoing minor procedures in the emergency department, and may be necessary for the safety of a combative or uncooperative patient, as well as the safety of the medical provider. Traditionally, medications are delivered orally, intravenously, or
23. What is the main function of EDTA in endodontics A. Decalcification of dentine B. Cleaning debris from root canal 24. Which is NOT TRUE in relation to the prescription of 5mg or 10mg of diazepam for sedation A. B. Patient commonly complain of post operative headache An acceptable level of anxiolytic action is obtained when the drug is given one hour preoperatively C. There is a profound amnesic action and no side affects D. Active metabolites can give a level of sedation up to 8 hours post operatively E. As Benzodiazepine the action can be reversed with Flumazepil
You can also read more about dental sedation here. Feel free to contact our office with any questions or concerns you may have.