Comparative study of hemodynamic changes caused by diazepam and midazolam during third molar surgery: a randomized controlled trial

Abstract

The aim of the present study was to compare hemodynamic changes using midazolam 7.5 mg and diazepam 10.0 mg during the surgical removal of symmetrically positioned third molars. A prospective, randomized, double-blind, clinical trial was carried out involving 120 patients divided into three groups: Group 1 (diazepam and placebo), Group 2 (midazolam and placebo), and Group 3 (diazepam and midazolam). Each subject underwent two surgeries on separate occasions under local anesthesia. The following parameters were assessed at five different times (T0, T1, T2, T3, and T4): systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP, respectively); heart rate (HR); oxygen saturation (SpO(2)); rate pressure product (RPP); and pressure rate quotient (PRQ). Statistically significant differences were found regarding heart rate at T2 and T3 (p < 0.005) in Group 2, with a higher rate occurring during midazolam administration. Moreover, significant differences in rate pressure product were found at T2, T3, and T4 in this group, with higher values also occurring during midazolam administration. In Group 3, significant differences in diastolic blood pressure were found at T3 and T4, with higher values occurring during diazepam administration, whereas a higher heart rate occurred at T3 with midazolam. Midazolam 7.5 mg and diazepam 10.0 mg exert an influence on some hemodynamic parameters without perceptible clinical changes in healthy patients undergoing lower third molar surgery.

Inhibition of Soluble Epoxide Hydrolase as a Novel Approach to High Dose Diazepam Induced Hypotension

“…In our study, DZP caused a dose dependent decrease in BP (Figure 1), which is consistent with previous studies[35]. Hypotension induced by both doses of DZP lasted well beyond the short plasma elimination or brain disappearance half life of DZP, which is reported to be about 8 min each following i.v.…”

Effect of Diazepam on 24-Hour Blood Pressure and Heart Rate in Healthy Young Volunteers

“…No interference with orthostatic regulation mechanisms was detected [17]. As regards the effects of diazepam premedication in patients undergoing invasive diagnostic procedures, an increase in resting HR and a reduction of vagal tone were reported during bronchoscopy [18] and gastroscopy [19], whereas no significant changes were observed during coronary angiography [20] and molar surgery [21]. The use of diazepam for inducing anesthesia was found to produce a transient depression of baroreflex function and a reduction of plasma noradrenaline [22].…”

Comparação das alterações hemodinâmicas entre dois benzodiazepínicos frente à sedação consciente em exodontias de terceiros molares: um protocolo de revisão sistemática

“…Entre as diferentes vias de sedação em Odontologia (oral, retal, intramuscular, intravenosa e inalatória), a sedação oral é um meio mais acessível para os dentistas lidarem com a ansiedade do paciente, por ser bem aceito, principalmente quando comparado à administração parenteral, que requer perfuração por agulha, o que gera um maior grau de estresse e ansiedade no paciente, valendo-se frisar que a via parenteral não é legalmente autorizada para ser empregada por Cirurgiões Dentistas no Brasil (Araújo et al, 2018;Kapur & Kapur, 2018;Morais et al, 2015). Contudo, como qualquer outra abordagem, a sedação oral pode apresentar algumas limitações devido à farmacocinética relacionada à via oral, como início de ação mais demorada e variável e embora possa ajudar pacientes com níveis leves a moderados de ansiedade, essa técnica pode não ser eficaz em pacientes extremamente ansiosos (Araújo et al, 2018).…”