Mitchell P F
J Am Dent Assoc. 1980 Sep;101(3):492-5. doi: 10.14219/jada.archive.1980.0299.
Intravenous diazepam is an excellent anxiolytic drug for dental patients. Thrombophlebitis associated with its use has prompted this review. Recognition and management of thrombophlebitis are discussed along with the causes of vascular injury after intravenous diazepam. In two histologic studies, Graham and others thought it unlikely that precipitated crystals of diluted diazepam caused postinjection vasculopathology. It seems to be an inherent property of the vehicle or the drug itself. The reviewed methods of minimizing thrombophlebitis after intravenous diazepam are with hepari flush or saline solution flush, steroids, vein size and venipuncture site, the use of a different vehicle, dilutions, and the use of other benzodiazepines. Lorazepam, midazolam, and flunitrazepam are relatively new benzodiazepines that produce less thrombophlebitis than diazepam after injection. These newer benzodiazepines are still being investigated and more clinical trials must be done to recommend any of them as alternatives to intravenous diazepam in dentistry.
静脉注射地西泮对牙科患者来说是一种极好的抗焦虑药物。与其使用相关的血栓性静脉炎促使了本次综述。本文讨论了血栓性静脉炎的识别与处理，以及静脉注射地西泮后血管损伤的原因。在两项组织学研究中，格雷厄姆等人认为稀释后的地西泮析出的晶体不太可能导致注射后血管病变。这似乎是载体或药物本身的固有特性。综述了静脉注射地西泮后将血栓性静脉炎降至最低的方法，包括肝素冲洗或生理盐水冲洗、使用类固醇、静脉大小和静脉穿刺部位、使用不同的载体、稀释以及使用其他苯二氮䓬类药物。劳拉西泮、咪达唑仑和氟硝西泮是相对较新的苯二氮䓬类药物，注射后产生的血栓性静脉炎比地西泮少。这些较新的苯二氮䓬类药物仍在研究中，必须进行更多的临床试验，才能推荐其中任何一种作为牙科中静脉注射地西泮的替代品。
