Amnesia for Dental Procedures and Mood Change Following Treatment with Nitrous Oxide or Midazolam

File, Sandra E.; Easton, P.; Skelly, A M

doi:10.1097/00004850-199100630-00005

Cited by 17 publications

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“…A previous study using lower doses of both drugs (File et al, 1991) found a greater reduction in anxiety when dental treatment was finished in patients sedated with midazolam compared with nitrous oxide. No differences at T3 were found in the present study, but more importantly, the improvement in self-rated mood and bodily symptoms at T2, during dental treatment, was significantly better in patients who had been sedated with nitrous oxide than with midazolam.…”

Section: Discussionmentioning

confidence: 86%

“…When they do finally seek treatment they are unable to receive this without sedation. Both nitrous oxide by inhalation and intravenous benzodiazepines are used and have been found to reduce self-rated anxiety when pre-to post-treatment ratings are compared (File et al, 1986(File et al, , 1991Skelly et al, 1992), although these reductions reflect the combined result of drug treatment and termination of dental treatment. Both normal and dentally phobic patients felt a significant reduction in anxiety whilst breathing nitrous oxide just before the start of dental treatment .…”

Section: Introductionmentioning

confidence: 99%

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Self‐ratings by phobic patients during dental treatment: Greater improvement with nitrous oxide than midazolam

Goodall¹,

File²,

Sanders³

et al. 1994

Human Psychopharmacology

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The efficacy of intravenous midazolam and nitrous oxide inhalation at reducing self-rated mood and bodily symptoms was compared in patients referred to a dental sedation unit because their dental fears precluded treatment undrugged. Fifty-eight per cent of our patients could be randomly allocated to drug treatment, the others were assigned on clinical grounds. When they arrived for their first treatment, the clinically allocated patients (n = 40) were significantly more anxious, tense and restless than those randomly allocated (n = 61). Both drugs reduced ratings of anxious, tense, discontented and restlessness, but the improvements were greater with nitrous oxide. Nitrous oxide reduced ratings of irritable and depressed, but patients treated with midazolam only showed reductions when dental treatment was finished. The scores for 70 patients were analysed over two treatment days; their pre-sedation scores of tense, depressed and discontented were lower on day 2 than on day I, with the randomly allocated group showing greater reduction. Nitrous oxide remained superior on day 2. Thirty-eight patients completed 3 days of treatment; there were no further reductions in baseline ratings and the superiority of nitrous oxide was maintained.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Self‐ratings by phobic patients during dental treatment: Greater improvement with nitrous oxide than midazolam

Goodall¹,

File²,

Sanders³

et al. 1994

Human Psychopharmacology

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“…These scales have mainly been used to assess the effects of benzodiazepines, by the control and nitrous oxide groups, for spoken and written instructions. ***p < 0.001 compared with control group but we have found them sensitive to the effects of nitrous oxide and suitable for use in dental patients (see File et al, 1991). …”

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confidence: 74%

Effects of nitrous oxide on memory for instructions in dental patients

File¹,

Balakrishnan²,

Murray³

et al. 1992

Human Psychopharmacology

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Outpatients attending for conservative dental treatment were presented with eight instructions which they were asked to remember. The instructions were either written or spoken, and were in a positive or negative form. Patients treated with nitrous oxide remembered fewer instructions than those treated with local analgesia alone, and this effect of nitrous oxide was particularly marked for written instructions. Patients receiving local analgesia alone were more likely to remember positive than negative instructions in their original syntactical form, but this bias was not evident in the nitrous oxide group. In a second experiment both normal and dentally phobic patients were read dental and general instructions both before and during inhalation of 30 per cent nitrous oxide. Both groups showed a nitrous oxide-induced reduction in partially recalled instructions. There was interesting evidence for a different attentional bias in our two patient groups. The normal group remembered more general than dental instructions, whereas the phobic group showed the opposite pattern, yielding a significant patient group x type of instruction interaction.KEY woms-Nitrous oxide, memory, attention, syntax, cognitive bias. INTRODUCTIONThere have been several reports of impairments in memory for lists of digits and nouns following inhalation of 30 per cent nitrous oxide (Steinberg, 1954;Kortilla et a/., 1981), the impairments being in acquisition (Steinberg and Summerfield, 1957;Block et al., 1988;Mewaldt et al., 1988). Impairments are not restricted to artificial material, but have also been found in recognition of faces (Norton et al., 1984) and memory for dental events (File et al., 1991).Task difficulty seems to determine whether or not memory impairments are detected after nitrous oxide. Thus. no impairments were found in an easy recall task (Norton et al., 1984) or in a recognition task made easier by repetitions (Block et al., 1988). The purpose of Experiment 1 was to investigate whether clinically used concentrations of nitrous oxide reduced memory for dental instructions and if any such reduction was dependent on the syntax of the instructions and whether they were written or spoken. Mehler (1963) found better recall of active, affirmative instructions than of passive or negative ones, and File and Jew (1973) also found * Author to whom correspondence should be addressed.better recall of airline safety instructions when these were positive, rather than negative, and when passengers heard them rather than read them.In Experiment 2 we investigated whether there was an interaction between the effects of nitrous oxide and the patient group. In Experiment 1 and the File et al. (1992) study the patients receiving nitrous oxide were dental phobics and their memory was compared with a control group receiving similar dental treatment under local analgesia alone. In Experiment 2 we therefore examined the effects of nitrous oxide on memory for instructions in a group of normal and a group of dentally phobic patients. There is some evi...

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“…L'amnésie est indépendante de l'effet sédatif [33]. Il a été montré que même si la sédation a été titrée correctement jusqu'à l'objectif souhaité, l'amnésie n'a pas forcément lieu.…”

Section: Amnésie Antérogradeunclassified

Le midazolam. 1^repartie : pharmacologie

Descroix

André²,

Pong

2012

Med Buccale Chir Buccale

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Résumé -Les benzodiazépines constituent une classe de médicaments qui regroupent un nombre important de molécules ayant des propriétés pharmacologiques communes (anxiolytiques, sédatives, hypnotiques, amnésiques, myorelaxantes et anticonvulsivantes). Il s'agit pour la plupart de molécules hautement lipophiles dont les indications thérapeutiques sont larges, allant de l'anxiolyse à l'anesthésiologie. Le midazolam, de part ses propriétés physicochimiques singulières, se démarque des autres benzodiazépines et représente à ce titre la molécule la plus étudiée et la plus utilisée en anesthésiologie, notamment pour la sédation quelle qu'en soit la profondeur. Avant d'envisager ses indications et son utilisation pour la sédation consciente en chirurgie orale, il convient de préciser ses différentes caractéristiques pharmacologiques. Abstract -Midazolam. Part I: Pharmacology.Benzodiazepines are a class of drugs that include a large number of molecules with common pharmacological properties (anxiolytic, sedative, hypnotic, amnesic, anticonvulsant and muscle-relaxing). They are mostly highly lipophilic molecules which therapeutic indications are broad, ranging from anxiolysis to anesthesia. Midazolam, because of its unique physicochemical properties, is different from other benzodiazepines and thus represents the molecule most studied and most widely used in anaesthesia, including sedation regardless of depth. Before considering its indications and its use for conscious sedation in oral surgery, it should clarify its different pharmacological characteristics.

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Amnesia for Dental Procedures and Mood Change Following Treatment with Nitrous Oxide or Midazolam

Cited by 17 publications

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Self‐ratings by phobic patients during dental treatment: Greater improvement with nitrous oxide than midazolam

Self‐ratings by phobic patients during dental treatment: Greater improvement with nitrous oxide than midazolam

Effects of nitrous oxide on memory for instructions in dental patients

Le midazolam. 1^repartie : pharmacologie

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Amnesia for Dental Procedures and Mood Change Following Treatment with Nitrous Oxide or Midazolam

Cited by 17 publications

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Self‐ratings by phobic patients during dental treatment: Greater improvement with nitrous oxide than midazolam

Self‐ratings by phobic patients during dental treatment: Greater improvement with nitrous oxide than midazolam

Effects of nitrous oxide on memory for instructions in dental patients

Le midazolam. 1repartie : pharmacologie

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Le midazolam. 1^repartie : pharmacologie