• Natural Product Sciences
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• 제17권4호
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• pp.342-349
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• 2011

This study was performed to determine the composition of phenolic substances contained in the leaves of Cirsium setidens (Compositae), validate the high-performance liquid chromatography (HPLC) method, and determine the in vivo sedative effect of the main component pectolinarin. Six phenolic compounds isolated from C. setidens were spectroscopically identified as chlorogenic acid (1), hyperoside (2), 3,4-di-O-caffeoylquinic acid (3), caffeic acid methyl ester (4), linarin (5), and pectolinarin (6) and then used as standard compounds for HPLC analysis. HPLC proved to be precise, accurate, and sensitive for the simultaneous analysis of the phenolic substances. In particular, six compounds showed good regression ($R^2$ > 0.999) within test ranges and recovery was in the range of 95.4 - 104.8%. The content of pectolinarin was considerably higher (156.48 mg/g) than those of other phenolic substances including the other flavone glycoside, linarin (18.99 mg/g). The contents of other phenolic substances, in order, were chlorogenic acid (8.41 mg/g), 3,4-di-O-caffeoylquinic acid (5.74 mg/g), hyperoside (4.33 mg/g), and caffeic acid methyl ester (0.51 mg/g). Oral administration with compound 6 (10 and 20 mg/kg) enhanced the sleeping time induced by pentobarbital in mice, indicating that it has a sedative effect.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권4호
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• pp.369-376
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• 2021

In adult patients with dental phobia, dental treatment may be difficult, or may not be possible. Depending on the level of fear or anxiety, non-pharmacological or pharmacological behavior management techniques are used in the dental treatment of such patients. Among the pharmacological behavior management techniques, minimal sedation, that is, the lowest depth of sedation, can be easily obtained in adult patients using oral sedatives, does not require special equipment or tools, and does not affect ventilatory and cardiovascular function. Diazepam is an anxiolytic drug belonging to the benzodiazepine family that, in addition to relieving anxiety, produces muscle relaxation, and is a representative drug used in adult patients with fear of dental treatment. Herein, we report the case of a 50-year-old woman with severe dental fear who successfully underwent long-term dental treatment in approximately 20 visits with minimal sedation using oral diazepam. In addition, we reviewed the considerations for the use of benzodiazepines for minimal sedation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권4호
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• pp.260-266
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• 2012

Purpose: The purpose of this study is to identify the changes of a physiologic nature and the sedative parameters associated with dexmedetomidine and pethidine, in patients undergoing plate and screw removal surgery, after orthognathic surgery. Methods: Twenty-three patients were sedated with dexmedetomidine and pethidine during plate and screw removal, after orthognathic surgery. An initial loading dose of dexmedetomidine ($1.0{\mu}g/kg$ infused over 10 minutes) was followed by a maintenance dose ($1.0{\mu}g/kg/hr$). Systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation, and heart rate were monitored. Perioperative amnesia and anxiety were recorded. Results: Significant changes were found in the blood pressure and heart rate (Freidman test, P<0.05), but not in oxygen saturation (Freidman test, P>0.05). Amnesia during local injection was observed in eight patients (34.8%). Compared with the preoperative anxiety score, the intraoperative anxiety score was decreased. Conclusion: In this study, we found cardiovascular and respiratory stability in intravenous sedation using dexmedetomidine with pethidine, in plate and screw removal, after orthognathic surgery. Furthemore, intravenous sedation using dexmedetomidine with pethidine shows adequate analgesic and sedative effects.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권4호
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• pp.436-441
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• 2000

The purpose of this retrospective study is to investigate the effects of conscious sedation in an outpatient setting. Data from 292 patients (154 males, 138 females), sedated for minor oral surgery, were studied using various parameters including age and sex distribution, as well as according to procedures and each drug group. Results show that this intravenous conscious sedation technique is a safe and effective method of controlling behaviour, but one has to be prepared to deal with any emergencies or complications. The specific results are as follows: 1. Most procedures (265/292) were used to Valium mixed with Demerol and Midazolam mixed with Demerol. 2. Valium revealed a high incidence of pain upon injection and symptoms limited to daily activity and thrombophlebitis. 3. Nausea and vomiting manifested in the procedure using Demerol. 4. The patient manifested comfort similar in response to the same drugs used in another treatment.

• 대한장애인치과학회지
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• 제3권1호
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• pp.1-5
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• 2007

Patients of mental disorder have more missing teeth than general population because of the difficulty of oral hygiene management. In addition, especially Down syndrome patients etc., congenital dental problems develop more frequently. Therefore, prosthetic rehabilitation treatments for missing teeth in mental disorder patients are required more urgently. In other words, a removable partial denture may be very difficult for such patients to wear and manage. So in this review article we reviewed implant therapeutic modes for mental disorder patients based on previous reports. It should be understood that implant treatments are not impossible for mental disorder patients, and if implants could be a good method that could provide them good quality care, so implant should be included in treatment plans before surgery. Before surgery it should be evaluated that patients ability to manage themselves their ability to manage themselves should be evaluated and also should be evaluated whether general anesthesia or sedative treatment is required for the treatment, and whether their cooperation is good enough.

• 대한치과마취과학회지
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• 제12권3호
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• pp.173-176
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• 2012

Certain oral procedures require a sedated patient who is responsive to allow for the mouth opening and position change. Dexmedetomidine is a relatively selective alpha2-adrenoceptor agonist with sedative, analgesic, amnestic, and anesthetic-sparing effects. Large dose dexmedetomidine is suitable as a single agent for sedation and anxiolysis for plate removal in a patient with bilateral sagittal split osteotomy and Lefort 1 osteotomy with genioplasty.

• 대한치과마취과학회지
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• 제7권2호
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• pp.126-130
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• 2007

Sedation is often indicated for the relief of anxiety for outpatient oral surgery. In combination with local anesthesia, it is safe and effective method of treatment. However, it is not always effective in allowing the physician to complete the planned oral surgery procedure. On occasion, a procedure is left unfinished due to patient combativeness and discomfort and hypertension in spite of increase in sedative doses. Episodic increases in blood pressure were most commonly caused by light anesthesia or sedation and by the patient's experience of pain during treatment. Female patient was 42 years old. blood pressure is 150/90 mmHg. Extraction and implant surgery was done under IV sedation. During seadtion, her blood pressure was increased (200/100 mmHg). Surgery was stopped. She was done monitoring blood pressure. The blood pressure was decreased to 130/90 mmHg. Sedation was failed due to significant hypertension. Blood pressure is seldom increased during sedation but we should evaluate the patient's medical history and know guideline for hypertension crisis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권4호
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• pp.229-238
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• 2017

Objectives: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. Materials and Methods: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study. The initial dose of MDZ was determined by body mass index (BMI) and weight. In the case of insufficient sedation at the beginning of surgery, additional doses were injected. During surgery, peripheral oxygen saturation, bispectral index score (BIS), heart rate, and blood pressure were monitored and recorded. The predictor variables were sex, age, BMI, sleeping time ratio, dental anxiety, Pederson scale, and initial dose of MDZ. The outcome variables were additional administration of MDZ, observer's assessment of alertness/sedation, intraoperative amnesia, and patient satisfaction. Descriptive statistics were computed, and the P-value was set at 0.05. Results: Most patients had an adequate level of sedation with only the initial dose of MDZ and were satisfied with the treatment under sedation; however, 19 patients needed additional administration, and 13 patients were unsatisfied. In multivariable logistic analysis, lower age (odds ratio [OR], 0.825; P=0.005) and higher dental anxiety (OR, 5.744; P=0.003) were related to additional administration; lower intraoperative amnesia (OR, 0.228; P=0.002) and higher BIS right before MDZ administration (OR, 1.379; P=0.029) had relevance to patient dissatisfaction. Conclusion: The preoperative consideration of age and dental anxiety is necessary for appropriate dose determination of MDZ in the minor oral surgery under IVS. The amnesia about the procedure affects patient satisfaction positively.

• 동의신경정신과학회지
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• 제13권2호
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• pp.195-211
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• 2002

Gagamguibitang, a composite Korean medicinal drug prescribed by us, was evaluated for its sedative effects by measurements of potentiation on pentobarbital-induced sleeping time, anticonvulsive activities in animal model, inhibitory effect on GABA transaminase activity, and antioxidative activities in vitro- and/or in vivo assay. The results were summerized as follows : 1. Gagamguibitang showed about 2-fold prolongation of pentobarbital-induced sleeping time compared to the control group after administration(p.o) with 2.0g/kg of mice body weight. 2. Gagamguibitang strongly lengthened onset time of pentylenetetrazole-induced convulsion, shortened the duration of convulsion and diminished the lethality after treatment(p.o) with 1.0g/kg of mice body weight. 3. Gagamguibitang inhibited dose-dependently the brain GABA transaminase activity in vitro compared to the control group and in vivo compared to the pentylenetetrazole-treated group. 4. Gagamguibitang inhibited effectively brain lipid peroxidation by 45.8% at a dose of l0mg/ml in vitro and by 47.5% after oral treatment with 0.5g/kg of mice body weight in vivo assay. 5. Gagamguibitang exhibited a potent scavenging activity on DPPH radical in a dose-dependent manner with ca. 92% activity at l0mg/ml. As a result, Gagamguibitang can be useful for the effective sedative drug in clinical application.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권2호
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• pp.83-89
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• 2023

Background: With advances in safety measures for anesthesia, conscious sedation has gained popularity in the field of dentistry and has become essential in dental practice worldwide. However, in Tanzania, intravenous (IV) sedation is rarely practiced in the dental field. Therefore, we report the establishment of sustainable IV conscious sedation in dental practices and subsequently train local OMS residents in Tanzania. Methods: In 2019, intravenous conscious sedation was initiated at the University Dental Clinic of the Muhimbili University of Health and Allied Science (MUHAS), Tanzania. During the preparatory phase of the program, local oral and maxillofacial surgeons (OMSs) were given a series of lecture notes that concentrated on different aspects of IV conscious sedation in dentistry. During the on-site training phase, an oral surgeon from the United States joined the OMSs for case selection, IV-conscious sedation procedures, and patient follow-up. Patients were recruited from existing patient records at the MUHAS Dental Clinic. Results: The first conscious IV sedation program in dentistry was successfully launched at the University Dental Clinic in Tanzania. The local team of OMSs was trained on the safe administration of sedative agents (midazolam or ketamine) to perform various minor surgical procedures in a dental office. Nine patients with different ages, body masses, and medical conditions benefited from the training. No complications were associated with IV conscious sedation in the dental office. Conclusion: This was the first successful "hands-on" training on IV conscious sedation provided to OMSs in Tanzania. It laid the foundation for the sustainable care of patients with special needs requiring oral health-related care in the country.