Corcuera-Flores J-R, Silvestre-Rangil J, Cutando-Soriano A, López-Jiménez J
School of Dentistry, C/Avicena s/n, 41009 Seville, Spain,
Med Oral Patol Oral Cir Bucal. 2016 Sep 1;21(5):e579-86. doi: 10.4317/medoral.20981.
The main objective of this systematic literature review is to identify the safest and most effective sedative drugs so as to ensure successful sedation with as few complications as possible.
A systematic literature review of the PubMed MEDLINE database was carried out using the key words "conscious sedation," "drugs," and "dentistry." A total of 1,827 scientific articles were found, and these were narrowed down to 473 articles after applying inclusion and exclusion criteria. These 473 studies were then individually assessed for their suitability for inclusion in this literature review.
A total of 21 studies were selected due to their rigorous study design and conduciveness to further, more exhaustive analysis. The selected studies included a total of 1,0003 patients classified as ASA I or II. Midazolam was the drug most frequently used for successful sedation in dental surgical procedures. Ketamine also proved very useful when administered intranasally, although some side effects were observed when delivered via other routes of administration. Both propofol and nitrous oxide (N2O) are also effective sedative drugs.
Midazolam is the drug most commonly used to induce moderate sedation in dental surgical procedures, and it is also very safe. Other sedative drugs like ketamine, dexmedetomidine and propofol have also been proven safe and effective; however, further comparative clinical studies are needed to better demonstrate which of these are the safest and most effective.
本系统文献综述的主要目的是确定最安全、最有效的镇静药物，以确保镇静成功且并发症尽可能少。
使用关键词“清醒镇静”“药物”和“牙科”对PubMed MEDLINE数据库进行系统文献综述。共找到1827篇科学文章，应用纳入和排除标准后缩小至473篇。然后对这473项研究逐一评估其是否适合纳入本综述。
由于研究设计严谨且有利于进一步深入分析，共选择了21项研究。所选研究共纳入10003例ASA I或II级患者。咪达唑仑是牙科手术中最常用于成功镇静的药物。氯胺酮经鼻给药时也证明非常有用，不过通过其他给药途径给药时会观察到一些副作用。丙泊酚和一氧化二氮（N2O）也是有效的镇静药物。
咪达唑仑是牙科手术中最常用于诱导中度镇静的药物，且非常安全。氯胺酮、右美托咪定和丙泊酚等其他镇静药物也已被证明安全有效；然而，需要进一步的比较临床研究，以更好地证明其中哪些是最安全、最有效的。
