Diazepam or midazolam for orotracheal intubation in the ICU?

Gehrke, Lísia; Oliveira, Roselaine Pinheiro de; Becker, Maicon; Friedman, Gilberto

doi:10.1590/1806-9282.61.01.030

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…One reason why dental professionals in Tanzania opt for diazepam is its wide availability and low cost. The low cost of diazepam has also been reported elsewhere [ 22 ].…”

Section: Discussionmentioning

confidence: 75%

Conscious sedation in dentistry: knowledge and practice among dental professionals in Tanzania

Sales

Sohal

Moshy

et al. 2021

J Dent Anesth Pain Med

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Background Conscious sedation is a useful adjunct in the treatment of patients in dentistry; however, a lack of knowledge among the dental profession regarding sedation is a restricting factor in the practice of dental sedation. Therefore, this study was conducted to assess the knowledge and practice of sedation in dentistry among dental professionals in Tanzania. Methods This was a cross-sectional study conducted for five months targeting all practicing dental professionals in Tanzania. A modified questionnaire contained 14 questions regarding knowledge about sedative agents and a section on the practice of sedation. The data obtained from this study were coded and entered into a computer program and analyzed using SPSS software version 23.0. The data are presented as frequencies and percentages in tables and charts. Statistical significance was set at P < 0.05. Results The age range of participants was between 24 and 63 years (mean 36.6 ± 7.7 years). There were 107 men (78.1%), and the male-to-female ratio was 3.6:1. The majority (76.6%) of participants only had an undergraduate dental degree. Thirty-one percent of participants only worked in publicly owned health facilities. Slightly more than half (59.9%) of participants had satisfactory knowledge regarding sedation in dentistry. There was no statistically significant association between the level of sedation-related knowledge and the demographic characteristics of the participants. Only 21.9% reported using sedation in their practice, and the most commonly used sedative drug was diazepam. The reasons for not using dental sedation in clinical practice included a perceived lack of knowledge on sedation, lack of equipment, and cost. Conclusion Most dental professionals in Tanzania have basic knowledge of sedation in dentistry, although knowledge regarding sedative agents is generally low. The practice of sedation in dentistry in Tanzania is very low compared to that in middle- and high-income countries. Inadequate knowledge, lack of equipment, and the cost of practicing sedation are the main reasons for not practicing sedation.

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“…One reason why dental professionals in Tanzania opt for diazepam is its wide availability and low cost. The low cost of diazepam has also been reported elsewhere [ 22 ].…”

Section: Discussionmentioning

confidence: 75%

Conscious sedation in dentistry: knowledge and practice among dental professionals in Tanzania

Sales

Sohal

Moshy

et al. 2021

J Dent Anesth Pain Med

View full text Add to dashboard Cite

show abstract

“…Cost of sedation was lower for diazepam compared to midazolam (1.4-1.8 vs. 9.4-16.2, p<0.001). 21 It is recommended to use diazepam in adult ICU for the patient who needs urgent intubation.…”

Section: Regarding To Diazepam or Midazolammentioning

confidence: 99%

<p>Evidence-Based Guideline for Adult Sedation, Pain Assessment, and Analgesia in a Low Resource Setting Intensive Care Unit: Review Article</p>

Neme¹,

Aweke²,

Micho³

et al. 2020

IJGM

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Background Agitation and anxiety occur frequently in ICU and affect about 30–80% of patients in ICU present with delirium worldwide, and it is associated with adverse clinical outcomes. This review aimed to systematically review articles and finally draw an evidence-based guideline for an area with limited resources. Methods The review was reported based on preferred reporting items for systemic and meta-analysis (PRISMA) protocol. We searched literature from PubMed, Google Scholar, and Medline database using keywords like the level of sedation, sedation score, pain assessment in ICU, and sedative drugs in ICU from an article published in English. After extraction with a patient population and exclusion, five randomized clinical trials, four systemic reviews and meta-analysis, four observation cohort study, and two practical guidelines were used for the review. Conclusion In addition to high validity and reliability, RASS has the advantage of easiness to remember for nurses making it a preferred sedation assessment tool in an adult ICU setting. Light sedation with daily interruption was recommended with an aim of an awake and alert patient ready for the weaning trial. Propofol was preferred when sedation is for a short duration and when intermittent awakening is required. Ketamine is the preferred induction for asthmatic hypotensive and patient requiring prolonged continuous sedation. With a similar time for sedation, diazepam shows a shorter time for intubation compared to midazolam. Besides diazepam has shown a cheaper cost of sedation than midazolam. This makes it a drug of preference in a low resource setting.

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“…Xylazine is the shortest acting α 2 -adrenergic agonist and has been widely used as preanaesthetic for immobilizing dogs as well as for sedative, muscle relaxant, and analgesic purposes (Sutil et al, 2017). Similarly diazepam is used as preanesthetic in both healthy and cardiovascular compromised dogs however it requires repeated injections and quick endotracheal incubation (Gehrke et al, 2015). Medetomidine hydrochloride is most potent α2-adrenoceptor selective agonist.…”

Section: Introductionmentioning

confidence: 99%

Clinico-biochemical study on different pre-anesthetic drugs combined with propofol for neutering dogs

Aslam

Akhtar

Khan

et al. 2019

IJAR

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The objective of present study was to select the best pre-anesthetic to be used in combination with propofol for neutering dogs. A prospective randomized study was conducted on 18 clinical cases of mongrel dogs admitted for neutering were subjected in to three groups (n=6). In group A (xylazine @ 2.2 mg/kg), group B (diazepam@ 0.25 mg/kg) and group C (medetomidine @ 40 µg/kg body weight), were injected intramuscular as preanesthetics. After 3-5 minutes of pre-anesthetic, the propofol injection @ 6 mg/kg of body weight was administered intravenous as anesthetic drug in all three groups. Analgesia was tested by the presence or absence of following reflexes - tail pricking, toes pinch, pedal reflex and patellar reflex. Rapid onset (9.13 ± 1.41 minutes) and long duration (59.67± 5.50 minutes) of analgesia was observed in group C compared other groups (onset 13.661±1.72 A, 20.16 ± 1.75 B minutes) and duration of analgesia (48.56 ± 4.61 A and 40.66± 5.46 B minutes). CBC, ALT, AST, ALP and blood urea nitrogen values were non-significantly (P e” 0.5) same within and between all three groups. There was significant (P d” 0.5) increase in ALT, AST, ALP, BUN and serum creatinine in group B at 24 hours interval. The results of our study showed that there was non significant decrease (P e” 0.5) in Hb and total erythrocytes count while non-significant increase (P e” 0.5) in total leukocyte count was noted in all three groups. The results showed that Medetomidine HCl in combination with propofol produce, rapid onset, and long duration of analgesia, with rapid and smooth recovery and no effects on haematological parameters of dogs.

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Diazepam or midazolam for orotracheal intubation in the ICU?

Cited by 4 publications

References 25 publications

Conscious sedation in dentistry: knowledge and practice among dental professionals in Tanzania

Conscious sedation in dentistry: knowledge and practice among dental professionals in Tanzania

<p>Evidence-Based Guideline for Adult Sedation, Pain Assessment, and Analgesia in a Low Resource Setting Intensive Care Unit: Review Article</p>

Clinico-biochemical study on different pre-anesthetic drugs combined with propofol for neutering dogs

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