Journal of Dental Research, Vol 63, 842-847, Copyright © 1984 by International & American Associations for Dental Research Online Journals
Differential pharmacology of drugs used for intravenous pre-medication
R. A. Dionne
The differential effects of drugs used for intravenous pre-medication are
reviewed using the results of controlled clinical trials in dental
outpatients. The evaluation of clinical success requires experimental
control of factors which can confound both the therapeutic and evaluation
processes. The evaluation of drugs which are given primarily to alleviate
anxiety requires that this effect be assessed by the patient's self-report
rather than by the clinician's estimate of drug effect based on external
manifestations. The results of the studies reviewed suggest that
intravenous diazepam accomplishes the therapeutic objectives of anxiety
relief, decreased pain perception, and amnesia. The addition of a narcotic,
while reducing the diazepam dose, does not result in any greater effect,
but does improve patient cooperation. It is concluded that diazepam,
administered to clinical end-point, accomplishes most of the goals of
intravenous pre-medication with minimal potential for adverse effects. The
use of additional agents may improve patient cooperation, but this possible
advantage must be weighed against the potential for increased systemic
effects.
