Skelly A M, Girdler N M, File S E
Department of Clinical Dental Surgery, Guy's Hospital, London.
Br Dent J. 1992 Feb 22;172(4):153-7. doi: 10.1038/sj.bdj.4807798.
Out-patients attending for removal of at least one lower third molar were randomly allocated to treatment with temazepam elixir (n = 7) or intravenous midazolam (n = 8), as well as local analgesia. Patients were tested prior to drug administration and at the end of surgery. Both drugs increased heart rate and midazolam also decreased diastolic blood pressure. The two drugs caused significant, equal increases in ratings of sedation, but the reduction of anxiety was significant only for midazolam. There was significant amnesia for material presented after drug administration, as well as for dental events and this was significantly greater for midazolam. The effects of these drugs in dental patients were compared with those in normal volunteers treated in an identical manner, but without oral surgery. The drugs had similar significant cardiovascular and amnesic effects in the volunteers and the same effects on mood ratings, even though volunteers and patients differed in their pretreatment levels of anxiety and discontent. The dentist's ratings of the sedation and operating conditions were excellent in both cases. Thus temazepam elixir provided a useful sedative for oral surgery, avoiding the complications of intravenous administration. However, for equivalent levels of sedation, midazolam had greater anxiolytic and amnesic effects than temazepam.
前来拔除至少一颗下颌第三磨牙的门诊患者被随机分配接受替马西泮酏剂治疗（n = 7）或静脉注射咪达唑仑治疗（n = 8），同时给予局部镇痛。在给药前和手术结束时对患者进行测试。两种药物均使心率增加，咪达唑仑还使舒张压降低。两种药物引起的镇静评分显著且相等地增加，但仅咪达唑仑对焦虑的减轻具有显著意义。给药后呈现的材料以及牙科事件均存在显著的遗忘，且咪达唑仑引起的遗忘更为显著。将这些药物在牙科患者中的作用与以相同方式治疗但未进行口腔手术的正常志愿者中的作用进行比较。尽管志愿者和患者在治疗前的焦虑和不满水平存在差异，但这些药物在志愿者中具有相似的显著心血管和遗忘作用，并且对情绪评分的影响相同。在这两种情况下，牙医对镇静和手术条件的评分均为优秀。因此，替马西泮酏剂为口腔手术提供了一种有用的镇静剂，避免了静脉给药的并发症。然而，对于同等程度的镇静，咪达唑仑比替马西泮具有更强的抗焦虑和遗忘作用。
