An ideal i.v. sedative for dentistry should provide anti-anxiety and analgesic activity, amnesic action, and patient cooperation without depression of the cardiorespiratory system and with rapid recovery. Lorazepam does not provide any advantages over the currently available agents, but midazolam, a new water-soluble benzodiazepine, and later selective benzodiazepine receptor antagonists may play an important role in outpatient sedation.
References
1.
Conner, J.T. : Sedation vs. Relief of Anxiety, Anesthesiology48:300,1978.
2.
Korttila, K. ; Levanen, J.; and Auvinen, J.: Failure of Intramuscularly Administered Lorazepam and Scopolamine-Morphine Premedication to Produce Amnesic Effects to Supplement Conduction Anaesthesia, Acta Anaesthesiol Scand24:325-330,1980.
3.
Dionne, R.A.: Development of Model to Evaluate Intravenous Anti-Anxiety Agents in Dental Outpatients. Ph.D. dissertation, Virginia Commonweath University , Richmond, VA, 1980.
4.
Dionne, R.A. ; Driscoll, E.J.; Gelfman , S.S.; Sweet, J.B.; Butler, D.; and Wirdzek, P.R.: Cardiovascular and Respiratory Response to Intravenous Diazepam, Fentanyl and Methohexital in Dental Outpatients, J Oral Surg39:343-349, 1981.
5.
Korttila, K. ; Tarkkanen, L.; Aittomaki , J.; Hyöty, P.; and Auvinen, J.: The Influence of Intramuscularly Administered Pethidine on the Amnesic Effects of Intravenous Diazepam During Intravenous Regional Anaesthesia, Acta Anaesthesiol Scand25:323-327, 1981.
6.
Trieger, N.: Intravenous Sedation, Dent Clin North Am17:249-261, 1973.
7.
Korttila, K.: Amnesic and Residual Effects from Intravenous Sedation. In: Trends in Intravenous Anaesthesia, Aldrete, J.A. and Stanley, T.H., Eds., Chicago: Yearbook Medical Publishers , 1980, pp. 483-500.
8.
Korttila, K. : Recovery after Intravenous Sedation: A Comparison of Clinical and Paper and Pencil Tests Used in Assessing Late Effects of Diazepam , Anaesthesia31:724-731, 1976.
9.
Korttila, K. and Linnoila, M.: Psychomotor Skills Related to Driving after Intramuscular Administration of Diazepam and Meperidine, Anesthesiology42:685-691, 1975.
10.
Korttila, K. ; Linnoila, M.; Ertama , P.; and Hakkinen, S.: Recovery and Simulated Driving after Intravenous Anaesthesia with Thiopental, Methohexital, Propanidid or Alphadione, Anesthesiology43:291-299, 1975.
11.
Korttila, K. : Minor Outpatient Anesthesia and Driving, Mod Probl Pharmacopsych11-13:91-98, 1976.
12.
Korttila, K. : Recovery and Driving after Brief Anaesthesia , Anaesthetist30:377-382, 1981.
13.
Korttila, K.: Pharmacokinetics of Intravenous Non-Narcotic Anesthetics. In: Trends in Intravenous Anesthesia, Aldrete, J.A. and Stanley, T.H., Eds., Chicago: Yearbook Medical Publishers , 1980, pp. 13-42.
14.
Korttila, K.: Clinical Aspects of Pathways of Metabolism. In: Trends in Intravenous Anesthesia, Aldrete, J.A. and Stanley, T.H., Eds., Chicago : Yearbook Medical Publishers, 1980, pp. 75-90.
15.
Doenicke, A. ; Kugler, J.; and Laub, M.: Evaluation of Recovery and "Street-Fitness" by E.E.G. and Psychodiagnostic Tests after Anaesthesia , Can Anaesth Soc J14:567-583, 1967.
16.
Dubois, M.; Scott, D.F.; and Savege, T.M.: Assessment of Recovery from Short Anaesthesia Using the Cerebral Function Monitor, Br J Anaesth50:825-832, 1978.
Gregg, J.M. ; Ryan, D.E.; and Levin, K.H.: The Amnesic Actions of Diazepam, J Oral Surg32:651-664, 1974.
19.
Korttila, K. and Linnoila, M.: Skills Related to Driving after Intravenous Sedation: Dose-response Relationship with Diazepam, Br J Anaesth47:457-463, 1975.
20.
Korttila, K. ; Saarnivaara, L.; Tarkkanen , J.; Himberg, J.-J.; and Hytönen , M.: Comparison of Diazepam and Flunitrazepam for Sedation during Local Anaesthesia for Bronchoscopy , Br J Anaesth50:281-287, 1978.
21.
Korttila, K. ; Mattila, M.J.; and Linnoila , M.: Prolonged Recovery after Diazepam Sedation: The Influence of Food, Charcoal Ingestion and Injection Rate on the Effects of Intravenous Diazepam, Br J Anaesth48:333-340, 1976.
22.
O'Neil, R.; Verril, P.J.; Aellig , W.H.; and Laurence , D.R.: Intravenous Diazepam in Minor Oral Surgery, Br Dent J127:15-20, 1970.
23.
Korttila, K. and Linnoila, M.: Skills Related to Driving after Intravenous Diazepam, Flunitrazepam or Droperidol, Br J Anaesth46:961-969, 1974.
24.
Korttila, K. and Kangas, L.: Unchanged Protein Binding and the Increase of Serum Diazepam Levels after Food Intake, Acta Pharmacol Toxicol40:241-246, 1977.
25.
Korttila, K. ; Ghoneim, M.M.; Jacobs , L.; and Lakes, R.S.: Evaluation of Instrumented Force Platforms as a Test to Measure Residual Effects of Anaesthetics , Anesthesiology55: 625-630, 1981.
26.
Lakes, R.S. ; Korttila, K.; Eltoft , D.; DeRose , A.; and Ghoneim, M.M.: Instrumented Force Platform for Postural Sway Studies, IEEE Trans Biomed Engr28:725-729, 1981.
27.
Baird, E.S. and Hailey, D.M.: Delayed Recovery from a Sedative: Correlation of Plasma Levels of Diazepam with Clinical Effects after Oral and Intravenous Administration, Br J Anaesth44:803-808, 1972.
28.
Linnoila, M. ; Korttila, K.; and Mattila, M.J.: Effects of Food and Repeated Injections on Serum Diazepam Levels, Acta Pharmacol Toxicol36:181-186, 1975.
29.
Pandit, S.K. ; Heisterkamp, D.V.; and Cohen, P.J.: Further Studies of the Anti-Recall Effect of Lorazepam. A Dose-Time-Effect Relationship, Anesthesiology45:495-500, 1976.
30.
Pagano, R.R. ; Conner, J.T.; and Belleville , J.W.: Lorazepam, Hyoscine and Atropine as I.V. Surgical Pre-medicants, Br J Anaesth50:471-476, 1978.
31.
Dundee, J.W. ; Lilburn, J.K.; Nair , S.G.; and George, K.A.: Studies of Drugs Given before Anaesthesia. XXVI. Lorazepam, Br J Anaesth49:1047-1056, 1977.
32.
Stoller, K.P. ; Belleville, J.P.; and Belleville , J.W.: Visual Tracking following Lorazepam and Pentobarbital, Anesthesiology45:565-568, 1976.
33.
Seppala, T. ; Korttila, K.; Hakkinen , S.; and Linnoila, M.: Residual Effects and Skills Related to Driving after a Single Oral Administration of Diazepam, Medazepam or Lorazepam, Br J Clin Pharmacol3:831-841, 1976.
34.
Kanto, J. and Klotz, U.: Intravenous Benzodiazepines as Anaesthetics Agents. Pharmacokinetics and Clinical Consequences, Acta Anaesthesiol Scand26:554-659, 1982.
35.
Foster, A.; Gardaz, J.P.; Suter, P.M.; and Gemperle,
36.
M.: Respiratory Depression by Midazolam and Diazepam, Anesthesiology53:494-497, 1980.
37.
Al-Khudhairi, D.; Whitwam, J.G.; and McCloy , R.F.: Midazolam and Diazepam for Endoscopy, Anaesthesia37: 1002-1006, 1982.
38.
Kawar, P.; McGimpsey, J.G.; Gamble, J.A.S.; Browne, E.S.; and Dundee, J.W.: Midazolam as a Sedative in Dentistry, Br J Anaesth54:1137, 1982.
39.
Dundee, J.W. ; Kawar, P.; Gamble , J.A.S.; and Brophy , T.O.R.: Midazolam as a Sedative in Endoscopy, Br J Anaesth54:1136-1137, 1982.
40.
Fragen, R.J. ; Gahl, F.; and Caldwell, N.: A Water-Soluble Benzodiazepine, RO 21-3981, for Induction of Anaesthesia, Anesthesiology49:41-43, 1978.
41.
Korttila, K. and Aromaa, U.: Venous Complications after Intravenous Injection of Diazepam, Flunitrazepam , Thiopentone and Etomidate, Acta Anaesthesiol Scand24 :227-230,1980.
42.
Baestrup, C. and Nielses, M.: Neurotransmitters and CNS Disease. Anxiety , LancetI:1030-1034, 1982 .
43.
Study, R.E. and Barker, J.L.: Cellular Mechanisms of Benzodiazepine Action , JAMA247:2147-2151, 1982 .
44.
Darragh, A. ; Lambe, R.; Kenny , M.; Brick, I.; and Taaffe, W.: RO 15-1788 Antagonizes the Central Effects of Diazepam without Altering Diazepam Bioavailability , Br J Clin Pharmacol14:677-682, 1982.
45.
Lauven, P.M. ; Stoeckel, H.; Schwilden , H.; Arendt, R.; Greenblatt, D.J.; and Schütter , J.: Application of Benzodiazepine Antagonist (RO 15-1788) under Steady-State Conditions of Midazolam, Anesthesiology57:A325, 1982.
46.
Schwilden, H.; Stoeckel, H.; Lauven , P.M.; and Schüttler , J.: Action of Benzodiazepine Antagonist during Midazolam Infusion in Steady-State: Quantitative EEG Studies , Anesthesiology57:A326, 1982.
47.
Doenicke, A. ; Suttmann, A.; Kugler , J.; Kapp, W.; and Wolf, R.: Pilot Study of Benzodiazepine Antagonist , Br J Anaesth54:1131-1132, 1982 .
