Comparison of the Effect of Electrical Stimulations on the Chin Skin on Autonomic Nervous Activities During Propofol Sedation With or Without Midazolam

Sawaguchi, Karin; Matsuura, Nobuyuki; Ichinohe, Tatsuya

doi:10.1016/j.joms.2016.03.040

Cited by 5 publications

(4 citation statements)

References 45 publications

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“…33 Furthermore, our results support those of the previous study reporting that the combined use of propofol and intravenous midazolam maximized the therapeutic effects of each drug alone. 34,35 Our study has several limitations. Because of its retrospective design, a potential bias cannot be completely excluded.…”

Section: Discussionmentioning

confidence: 94%

The Effect of Adding Midazolam to Propofol Intravenous Sedation to Suppress Gag Reflex During Dental Treatment

Yamamoto

Fujii-Abe

Fukayama

et al. 2018

Anesthesia Progress

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We retrospectively investigated the efficacy and safety of propofol administration alone and in combination with midazolam for gag reflex suppression during dental treatment under intravenous sedation. We included 56 patients with an overactive gag reflex who were to undergo dental treatment under intravenous sedation. They were divided into propofol (P group, n = 22) and midazolam with propofol (MP group, n = 34) groups. The P group received propofol alone, while the MP group received midazolam (0.04 mg/kg) prior to target-controlled infusion (TCI) of propofol (titrated for adequate sedation). The patients' anesthetic records were evaluated for vital sign changes, adverse cardiovascular or respiratory event frequency, the number of forced treatment interruptions, and the TCI-predicted cerebral propofol concentration at gag reflex suppression (posterior tongue stimulation with a dental mirror). No significant differences were observed between the 2 groups preoperatively. There were no cases of forced interruptions or significant respiratory compromise in either group. Cardiovascular adverse event frequency was lower in the MP group than in the P group (all p < .05). Our results suggest that propofol, when combined with midazolam, minimized cardiovascular effects compared with propofol alone when used to suppress the gag reflex in patients during dental treatment under intravenous sedation.

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Section: Discussionmentioning

confidence: 94%

The Effect of Adding Midazolam to Propofol Intravenous Sedation to Suppress Gag Reflex During Dental Treatment

Yamamoto

Fujii-Abe

Fukayama

et al. 2018

Anesthesia Progress

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“…The high number of unclear items is not unusual, as Faggion et al showed in their review about the risk of bias in animal experiments in implant dentistry (see also Figure 2) [76]. Five studies were excluded because they were related to stress and anxiety during surgery [42][43][44][45][46]; five were excluded because they were related to anesthesia [47][48][49][50][51]; and four were excluded because they studied the influence of the SNS on orthodontics [52][53][54][55]. Four publications dealt with the effect of the SNS on dental pulp [56][57][58][59].…”

Section: Resultsmentioning

confidence: 99%

The Sympathetic Nervous System in Dental Implantology

Kupka

Sagheb

Schiegnitz

2023

JCM

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The sympathetic nervous system plays a vital role in various regulatory mechanisms. These include the well-known fight-or-flight response but also, for example, the processing of external stressors. In addition to many other tissues, the sympathetic nervous system influences bone metabolism. This effect could be highly relevant concerning osseointegration, which is responsible for the long-term success of dental implants. Accordingly, this review aims to summarize the current literature on this topic and to reveal future research perspectives. One in vitro study showed differences in mRNA expression of adrenoceptors cultured on implant surfaces. In vivo, sympathectomy impaired osseointegration in mice, while electrical stimulation of the sympathetic nerves promoted it. As expected, the beta-blocker propranolol improves histological implant parameters and micro-CT measurements. Overall, the present data are considered heterogeneous. However, the available publications reveal the potential for future research and development in dental implantology, which helps to introduce new therapeutic strategies and identify risk factors for dental implant failure.

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“…The level of sedation was evaluated by the bispectral index (BIS) (70-80) using a BIS monitor (Nihon Kohden, Tokyo, Japan) and the Observer's Assessment of Alertness/Sedation (OAA/S) score (1-2). 4,5 Anxiety levels before treatment were evaluated using the Modified Dental Anxiety Scale (MDAS) and the State-Trait Anxiety Inventory (STAI-S and STAI-T). These were noted just before IMTM extraction.…”

Section: Methodsmentioning

confidence: 99%

“…3 Intravenous sedation with midazolam and propofol is often used to reduce anxiety and tension in patients during dental treatment. [4][5][6] Midazolam exhibits good amnesic and anxiolytic effects, and propofol has hypnotic and antiemetic effects 5,7 ; they are often used together for stable and secure sedation. 5 However, the effect of intravenous sedation on autonomic nerve activity and psychological states remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Effects of intravenous sedation on autonomic nerve activity and the psychological state during tooth extraction: A prospective non‐randomized controlled trial

Uchino

Yamashita

Kibe

et al. 2020

Oral Science International

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Purpose: Intravenous sedation is considered to decrease patient anxiety and tension during dental treatment, thereby reducing fluctuations in autonomic nerve activity and the risk of medical emergencies. We hypothesized that intravenous sedation would suppress the sympathetic nervous system during tooth extraction and relieve patient anxiety. Accordingly, the purpose of this study was to investigate the effects of intravenous sedation on autonomic nerve activity and psychological state during impacted mandibular third molar (IMTM) extraction. Methods: This prospective study included 40 healthy women scheduled for IMTM extraction under local anesthesia alone (control group; n = 20) or local anesthesia and intravenous sedation (sedation group; n = 20); of these, 34 women were evaluated. Heart rate variability (HRV) was analyzed to evaluate autonomic nerve activity. HRV and circulatory dynamics were measured during the treatment. The Modified Dental Anxiety scale and State-Trait Anxiety Inventory (STAI-S and STAI-T) scores were obtained before treatment. STAI-S scores were also obtained after treatment.Descriptive and bivariate statistical analyses were conducted, and a P-value <.05 was considered statistically significant. Results:The low-frequency/high-frequency ratio was lower in the sedation group than in the control group (P < .01). Compared with the control group, the sedation group showed a significantly greater decrease in post-treatment STAI-S scores relative to pre-treatment scores (P < .01). Conclusions:The findings suggest that sedation suppresses the sympathetic nervous system during IMTM extraction and decreases anxiety after the extraction. Further research should elucidate the mechanisms by which sedation suppresses the sympathetic nervous system.

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Comparison of the Effect of Electrical Stimulations on the Chin Skin on Autonomic Nervous Activities During Propofol Sedation With or Without Midazolam

Cited by 5 publications

References 45 publications

The Effect of Adding Midazolam to Propofol Intravenous Sedation to Suppress Gag Reflex During Dental Treatment

The Effect of Adding Midazolam to Propofol Intravenous Sedation to Suppress Gag Reflex During Dental Treatment

The Sympathetic Nervous System in Dental Implantology

Effects of intravenous sedation on autonomic nerve activity and the psychological state during tooth extraction: A prospective non‐randomized controlled trial

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