Lundgren S
Acta Anaesthesiol Scand. 1985 Oct;29(7):674-8. doi: 10.1111/j.1399-6576.1985.tb02279.x.
In a randomized cross-over study on sedation in outpatient oral surgery, subcutaneous administration of morphine-scopolamine was compared with rectal administration of diazepam. The mean dose of morphine was 0.13 mg kg-1 (range 0.13-0.24) and of diazepam 0.57 mg kg-1 (range 0.50-0.71). Apprehension, the determining factor for patients' preference for sedation method, the recovery from sedation and the postoperative course were studied. Both methods produced the desired effects. For diazepam, the effect was scored higher by the patient than the nurse observer and for morphine-scopolamine the opposite was found. Postoperative pain and patients' preference for sedation did not differ between the methods and the determining factor for the patients' preference for sedation method was the experience of stronger tranquilization. Side-effects such as prolonged recovery, nausea, dizziness, and dysphoria were frequent during the postoperative course after the morphine-scopolamine sedation but were not seen during diazepam sedation. Thus, rectal administration of diazepam should be preferred to morphine and scopolamine for sedation in minor oral surgery performed under local anesthesia.
在一项关于门诊口腔手术镇静的随机交叉研究中，比较了皮下注射吗啡 - 东莨菪碱与直肠给予地西泮的效果。吗啡的平均剂量为0.13 mg kg-1（范围0.13 - 0.24），地西泮的平均剂量为0.57 mg kg-1（范围0.50 - 0.71）。研究了焦虑（患者对镇静方法偏好的决定因素）、镇静恢复情况及术后过程。两种方法均产生了预期效果。对于地西泮，患者给出的效果评分高于护士观察者；而对于吗啡 - 东莨菪碱，情况则相反。术后疼痛及患者对镇静的偏好，在两种方法之间并无差异，患者对镇静方法偏好的决定因素是更强镇静的体验。在吗啡 - 东莨菪碱镇静后的术后过程中，诸如恢复时间延长、恶心、头晕及烦躁不安等副作用较为常见，但在地西泮镇静期间未出现。因此，在局部麻醉下进行的小型口腔手术中，直肠给予地西泮应比吗啡和东莨菪碱更适合用于镇静。
