• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.3
• /
• pp.241-244
• /
• 2011

Introduction: Intravenous sedation is performed to ensure smooth and safe surgery. Dental anxiety is a reaction to an unknown danger. The Spielberger's state-trait anxiety inventory (STAI) can be used to simultaneously evaluate the levels of state and trait anxiety. State anxiety is defined as subjective feelings of nervousness. This study assessed the presurgical anxiety using STAI and performed intravenous sedation for patients whose level of state anxiety was > stage IV. Based on our clinical experience, it is believed that higher doses of sedatives are needed to induce the desired levels of sedation in patients with a high level of state anxiety. Objectives: This study examined whether the sedative consumption of the patient with a high anxiety level increased. Patients and Methods: Patients with state anxiety scores of ${\geq}$51 were included in Group V, and those with state anxiety scores ranging from 42 to 50 were placed in Group IV. To induce sedation, intravenous access was established, and a bolus dose of 3.0 mg midazolam was administered intravenously. Sedation was maintained by administering a continuous infusion of propofol, which was aimed at achieving an Observer's Assessment of Alertness/Sedation scale of 10-12/20. In this study, midazolam was initially administered when the body movements appeared to occur or the blood pressure increased. This was followed by the administration of higher doses of propofol if low sedation was observed. Results: There were no significant differences in the patient demographics, duration of sedation, and doses of local anaesthetic agents between Groups IV and V. The midazolam dose and mean propofol dose needed to maintain comparable levels of sedation were significantly higher in Group V than in Group IV. Conclusion: In female patients, whose level of preoperative state anxiety is more than Stage V of STAI, a large quantity of sedatives is needed for intravenous sedation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.42 no.3
• /
• pp.162-165
• /
• 2016

We report a case of a morbidly obese man with an aortic aneurysm, in whom dental surgery was performed before elective cardiac surgery. His aortic aneurysm required emergency surgery. However, because of his morbid obesity, elective cardiac surgery was planned. Considering the high risk of infective endocarditis, dental surgery was required. Our patient was at a high risk of aortic rupture caused by hypertension and breathing difficulty in the supine position. Dexmedetomidine (DEX) is an anti-anxiety, sedative, and analgesic medicine that can stabilize circulatory dynamics and minimize blood pressure fluctuations. We administered intravenous DEX for sedation of the patient in Fowler's position. In conclusion, our understanding of the risk factors of DEX enabled us to perform safe invasive oral treatment.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.28 no.3
• /
• pp.430-440
• /
• 2001

Orally administered chloral hydrate is often used, because of it's wide margin of safety and relatively few sideeffects. Hydroxyzine is an antihistamine with sedative and anti-emetic properties. It has been used in conjunction with chloral hydrate to reduce the incidence of nausea and vomiting. But, it's therapeutic drug concentration has not been established. The purpose of this study was to assess the sedative effect and physiologic parameter of hydroxyzine of different doses in sedating young pediatric dental patients. Fifty uncooperative children, mean age 33.2 months, who needed at least four separate restorative visits, requiring local anesthesia participated in this study. On every visit, one of the following 4 different sedative regimen was given (1) 70mg/kg CH (2) 70mg/kg CH and 1mg/kg HD (3) 70mg/kg CH and 2mg/kg HD (4) 70mg/kg CH and 3mg/kg HD. Physiologic parameter was recorded and behavior was videotaped and rated using Ohio State University Behavior Rating Scale by one investigator, blind to the dose. The analyzed sedative effect of combined oral administration of 70mg/kg chloral hydrate and 2mg/kg hydroxyzine was superior to the other regimens. Evidence of adverse effect was not detected or reported during and/or after the procedures.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.32 no.1
• /
• pp.40-48
• /
• 2005

The purpose of present study was to compare the sedative effect of chloral hydrate and oral midazolam treatment. The study was conducted on twenty two child patients who required at least two visits. All the patients showed a good physical status (ASA-I). The patient was randomly assigned to receive drug either chloral hydrate 60mg/kg and hydroxyzine 25mg(Group I) or midazolam 0.5mg/kg and hydroxyzine 25mg(Group II) at each visit. Treatment procedures were divided into six stages. In each stage, sleep, crying, movement and overall behavior score were evaluated. The overall results can be summarized as follows: 1. Success rate was 59.9% in group I and was 77.8% in Group II. 2. Mean sleep score was $1.81{\pm}0.93$ in group I and was $1.44{\pm}0.69$ in group II (P<0.05). 3. Through all treatment procedures, no significant difference was observed between group I and group II in terms of crying, movement and overall behavior score(P>0.05). 4. There was no significant difference between the sex and the age(P>0.05). In regard to above results, oral midazolam considered to be a valuable drug as sedative agent in pediatric dentistry.

• Biomolecules & Therapeutics
• /
• v.23 no.5
• /
• pp.479-485
• /
• 2015

This study was performed to investigate the sedative-hypnotic activity of ${\gamma}$-aminobutyric acid (GABA)-enriched fermented marine organisms (FMO), including sea tangle (FST) and oyster (FO) by Lactobacillus brevis BJ20 (L. brevis BJ20). FST and FO were tested for their binding activity of the $GABA_A$-benzodiazepine and 5-$HT_{2C}$ receptors, which are well-known molecular targets for sleep aids. We also measured the sleep latency and sleep duration during pentobarbital-induced sleep in mice after oral administration of FST and FO. In $GABA_A$ and 5-$HT_{2C}$ receptor binding assays, FST displayed an effective concentration-dependent binding affinity to $GABA_A$ receptor, similar to the binding affinity to 5-$HT_{2C}$ receptor. FO exhibited higher affinity to 5-$HT_{2C}$ receptor, compared with the $GABA_A$ receptor. The oral administration of FST and FO produced a dose-dependent decrease in sleep latency and increase in sleep duration in pentobarbital-induced hypnosis. The data demonstrate that FST and FO possess sedativehypnotic activity possibly by modulating $GABA_A$ and 5-$HT_{2C}$ receptors. We propose that FST and FO might be effective agents for treatment of insomnia.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.22 no.6
• /
• pp.395-404
• /
• 2022

Hydroxyzine is one of the most popular oral sedatives used in pediatric dentistry. This study aimed to investigate the safety and possible side effects of sedation using hydroxyzine in pediatric dentistry. "Hydroxyzine," "Dental sedation," "Child," and "Safety" and their associated synonyms were searched using the Cochrane Library, Embase, PubMed, KISS, KMBASE, and KoreaMed databases. Academic information and portals of DBpia and RISS were also perused. Altogether, 340 papers were found, among which a total of 24 papers were selected according to the detailed criteria. Nine studies used hydroxyzine as monotherapy, and 10 studies compared its safety when hydroxyzine used as multitherapy. In addition, seven studies employed a drug regimen wherein hydroxyzine was one of the components. All these studies revealed that the adverse events specific to hydroxyzine usage were drowsiness and dryness of the mouth, and that there were respiratory complications due to a synergistic reaction of hydroxyzine. Although classified as a histamine blocker, hydroxyzine with its sedative, antiemetic, anticonvulsant, and anticholinergic properties is an oral sedative available without serious adverse events, If the proper dosage of the drug is used and its synergistic effects with other drugs are ascertained in the route of administration.

• Korean Journal of Oriental Medicine
• /
• v.1 no.1
• /
• pp.521-540
• /
• 1995

To elucidate the effects of Chokyungsan and Chunkeunchokyungtang, after oral administration of Chokyungsan and Chunkeunchokyungtang water extract in mice and rats, acute toxicity, analgesic, sedative, esoogenic actions, action on isolated uterine muscle were measured. The rlesults obtained were as follows: 1. The yield of water extract of Chokyungsan and Chunkeunchokyungtang was 24.5%, 32.2%, minimum lethal dose was 4,000mg/kg, which rarely had the acute toxicity in mice and rats. 2. The analgesic effects of Chokyungsan and Chunkeunchokyungtang by acetic acid induced writhing syndrome in mice were not remarkaely observed. 3. The relaxant action of Chokyungsan on on oxytocin induced contracted uterine muscle in estrogenized rats were not remarkably observed, but Chunkeunchokyungtang were remarked. 4. The sedative effects of Chokyungsan and Chunkeunchokyungtang by hexobabital sodium induced sleeping time in mice. 5. administration of Chokyungsan and Chunkeunchokyungtang caused remarkable increase in weight of rat's uterus.

• The Journal of Korean Medicine
• /
• v.15 no.2 s.28
• /
• pp.269-280
• /
• 1994

To elucidate the effects of Onkyungtang. after oral administration of Onkyungtang water extract in mice and rats, acute toxicity. analgesic. sedative, estrogenic actions. action on isolated uterine muscle were measured. The results obtained were as follows: 1. The yield of water extract of Onkyungtang was 24.5%, minimum lethal dose was 4,000mg/kg, which rarely had the acute toxicity in mice and rats. 2. The analgesic effects of Onkyungtang by acetic acid induced writhing syndrome in mice were not remarkably observed. 3. The relaxant action of Onkyungtang on oxytocin induced contracted uterine muscle in estrogenized rats were not remarkably observed. 4. The sedative effects of Onkyungtang by hexobarbital sodium induced sleeping time in mice were remarked. 5. Administration of Onkyungtang caused remarkable increase in weight of rat's uterus.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.15 no.2
• /
• pp.47-52
• /
• 2015

Sedation allows patients to maintain their airway independently and respond appropriately to physical stimulation and verbal command while maintaining a minimum depressed level of consciousness. Drugs commonly used for sedation of pediatric dental patients include a combination of chloral hydrate, hydroxyzine, and nitrous oxide-oxygen. Midazolam is a benzodiazepine and currently one of the most commonly used intravenous sedative agents. It can be easily titrated to provide a wide range of sedation, from conscious sedation to deep sedation, and exhibits a wide safety margin without severe respiratory and circulatory depression. At an appropriate dose, it also decreases patient anxiety and induces amnesia. We found that the submucosal administration of midazolam combined with chloral hydrate provided increased sedative effects and decreased the postoperative vomiting response compared with conventional chloral hydrate administration, with no significant difference in physiological responses. The depth of sedation can be titrated using this technique.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.21 no.6
• /
• pp.557-564
• /
• 2021

Background: Conscious sedation is a useful adjunct in the treatment of patients in dentistry; however, a lack of knowledge among the dental profession regarding sedation is a restricting factor in the practice of dental sedation. Therefore, this study was conducted to assess the knowledge and practice of sedation in dentistry among dental professionals in Tanzania. Methods: This was a cross-sectional study conducted for five months targeting all practicing dental professionals in Tanzania. A modified questionnaire contained 14 questions regarding knowledge about sedative agents and a section on the practice of sedation. The data obtained from this study were coded and entered into a computer program and analyzed using SPSS software version 23.0. The data are presented as frequencies and percentages in tables and charts. Statistical significance was set at P < 0.05. Results: The age range of participants was between 24 and 63 years (mean 36.6 ± 7.7 years). There were 107 men (78.1%), and the male-to-female ratio was 3.6:1. The majority (76.6%) of participants only had an undergraduate dental degree. Thirty-one percent of participants only worked in publicly owned health facilities. Slightly more than half (59.9%) of participants had satisfactory knowledge regarding sedation in dentistry. There was no statistically significant association between the level of sedation-related knowledge and the demographic characteristics of the participants. Only 21.9% reported using sedation in their practice, and the most commonly used sedative drug was diazepam. The reasons for not using dental sedation in clinical practice included a perceived lack of knowledge on sedation, lack of equipment, and cost. Conclusion: Most dental professionals in Tanzania have basic knowledge of sedation in dentistry, although knowledge regarding sedative agents is generally low. The practice of sedation in dentistry in Tanzania is very low compared to that in middle- and high-income countries. Inadequate knowledge, lack of equipment, and the cost of practicing sedation are the main reasons for not practicing sedation.