Inoue Takutoshi, Yamamoto Toru, Kishimoto Naotaka, Seo Kenji
Department of Anatomy, Teikyo University School of Medicine, Tokyo, JPN.
Division of Dental Anesthesiology, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata, JPN.
Cureus. 2025 Feb 16;17(2):e79079. doi: 10.7759/cureus.79079. eCollection 2025 Feb.
In recent years, there have been incidences of shortages of sedatives due to infectious diseases and supply issues. Dental anesthesiologists are required to have backup plans in case of supply shortages. Therefore, the aim of this study was to highlight the characteristics of diazepam and compare them with those of midazolam, and to explore the possibility of proposing useful situations for the use of diazepam in the modern intravenous sedation (IVS) scene. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Literature research was performed using PubMed and Google Scholar. After a detailed scrutiny, 20 English-language studies comparing midazolam and diazepam met the eligibility criteria. The evaluation points were classified into four categories: onset of action, recovery from sedation, injection pain, and amnesic effects. The results of this analysis review highlight that diazepam tends to have (a) a slower onset of action and recovery, (b) more injection pain, and (c) a weaker amnesic effect compared with midazolam, and that diazepam has to be administered at higher doses compared with midazolam. The use of two drugs in combination (e.g., midazolam + propofol) is now a common practice due to the advances in anesthetic drugs. In addition, dentistry has become more advanced and involves lengthy procedures, such as implant surgeries. Therefore, it is necessary to focus on the optimal drug dosages in the combination of diazepam and propofol, the postoperative recovery time, and the presence or absence of injection pain and amnesic effects. Diazepam may be an alternative to midazolam for IVS during prolonged dental procedures in situations of shortage and requires further study.
近年来，由于传染病和供应问题，出现了镇静剂短缺的情况。牙科麻醉师需要有应对供应短缺的备用计划。因此，本研究的目的是突出地西泮的特性，并将其与咪达唑仑的特性进行比较，探讨在现代静脉镇静（IVS）场景中提出地西泮有用应用情况的可能性。该研究遵循系统评价和Meta分析扩展的范围综述优先报告项目（PRISMA-ScR）指南。使用PubMed和谷歌学术进行文献研究。经过详细审查，20项比较咪达唑仑和地西泮的英文研究符合纳入标准。评估点分为四类：起效时间、镇静恢复、注射疼痛和遗忘效应。该分析综述的结果突出表明，与咪达唑仑相比，地西泮往往具有（a）起效和恢复较慢，（b）注射疼痛更明显，以及（c）遗忘效应较弱的特点，并且与咪达唑仑相比，地西泮必须以更高的剂量给药。由于麻醉药物的进步，现在联合使用两种药物（如咪达唑仑+丙泊酚）是一种常见的做法。此外，牙科技术已经更加先进，涉及诸如种植牙手术等冗长的程序。因此，有必要关注地西泮和丙泊酚联合使用时的最佳药物剂量、术后恢复时间以及是否存在注射疼痛和遗忘效应。在短缺情况下，地西泮可能是长时间牙科手术中IVS替代咪达唑仑的一种选择，需要进一步研究。
