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Neurosedation in dentistry of the disabled patient: the use of midazolam, propofol, and remifentanil.

Author(s): Collini S, Pinto G, Lejeune L, Di Carlo S, Meloncelli S, Barraco G, Gatto R

Affiliation(s): Department of Anesthesia and Resuscitation, 2nd Faculty of Medicine and Surgery, La Sapienza University, Rome, Italy.

Publication date & source: 2006-03, Minerva Stomatol., 55(3):99-113.

Publication type: Randomized Controlled Trial

AIM: This prospective randomized study, deals with neurosedation in dental treatment of 200 disabled patients and unable to cooperate, subdivided in 4 groups of 50 male only patients, with age ranging from 28 to 59 (39+/-11), ASA I-III. METHODS: The pharmaceuticals used were Midazolam (group MID) Propofol (group Prop) and Remifentanil. Midazolam and Propofol were used following a bolus-infusion sequence, both separately and in combination among themselves (MID\PROP group), or with an opioid, Remifentanil (MID\PROP\REMI group). ECG, heart rate , non invasive blood pressure (NIBP), SaO(2), EtCO(2) during the procedure were monitored. Induction time, duration of the sedation, recovery time and discharge were reported. RESULTS: The statistical analysis demonstrated the superiority of the PROP group for induction time in minute (3.1+/-0.5) in comparison with the MID group (10.6+/-2.1), the MID\PROP group (4.3+/-1.3) and MID\PROP\REMI (3.7+/-1.2). The recovery and discharge times have confirmed the superiority of the MID\PROP\REMI group in comparison with the other 3 groups. CONCLUSION: This combination proved best at leveraging the synergistic characteristics of each single pharmaceutical and minimizing the collateral effects of each individually.

Page last updated: 2006-11-04

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