Abstract
When intravenous sedation is administered to patients under continuous administration of benzodiazepine drug, there are some difficulties in determining the quantity and the kind of agents to be used sedation due to the problem of drug resistance. We conducted a comparative study between patients under continuous administration of benzodiazepine (n=8) and patients without drug administration for determining the difference in intravenous sedation administered at an affiliated hospital of Nippon Dental University, Niigata School of Dentistry.
As to the results, among the cases where optimal sedation was obtained with midazolam and where an increase in dosage or where a change to another agent was needed, there were no clear trend in the quantity and in the administration of the kind of oral medication observed. Moreover, considering that there are significant individual differences in the pharmacological clinical effect of benzodiazepine, it was considered to be difficult determine drug resistance of orally administered pharmaceutical drugs. From the above, as recognized previously the determination in establishing the quantity and the type of pharmaceutical agent to be administered, consideration for each case in accordance with the patient's clinical conditions is necessary (and of extreme importance).
In the case where benzodiazepine was not effective, Propofol can be used for substitution. From the fact that there is no specific receptor in the action mechanism of this agent and it has been reported that NMDA receptor is involved. Thus it can be considered to be appropriate as in this case that revealed a resistance to benzodiazepine.
