The Effectiveness of Intrarectal Diazepam Administration in Dental Practices for Uncooperative Children and Handicapped Patients

Abstract

Diazepam has been widely used as a sedative in dental practice. The effect of intravenous diazepam administration is rapid and reliable. However, the intravenous technique is difficult when it is used with uncooperative children or handicapped patients. Intrarectal diazepam administration is simple and reliable for these patients.
This study was carried out to investigate the effectiveness of intrarectal diazepam administration in dental treatment for uncooperative children and handicapped patients.
The study comprised of 35 uncooperative and handicapped patients, aged from 5 months to 20 years. There was a total of 66 dental treatments among the 35 patients.
The following results were obtained:
1) The technique for intrarectal diazepam administration was easy and the mean time spent for the administration was 1 minute and 1 second. A mean onset time was 8 minutes and 42 seconds and the interindividual differences were small.
2) The evaluation of the sedative effect during dental treatment resulted in the following 4 types: markedly effective 24.2%, effective 37.9%, slightly effective 22.7% and ineffective 15.2 %.
3) Diazepam was found to lessen markedly the involuntary movement associated with cerebral palsy and to be effective for the anxiety of patients who had slight mental retardation. However, diazepam was not effective for patients who had severe mental retardation or healty patients who were less than 3 years old.
4) Immediately after the administration of diazepam,4.5% of the patients passed stools. On the way home,55% of patients had difficulty in walking. During the night after the treatment,25% of patients complained of a vague feeling of discomfort and difficulty in falling asleep and 20% lost their appetite. On the next day after the treatment,15% complained of a vague feeling of discomfort and 10% lost their appetite.