scholarly journals Effectiveness and safety of oral sedation in adult patients undergoing dental procedures: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e043363
Author(s):  
Jimmy de Oliveira Araújo ◽  
Cristiane de Cássia Bergamaschi ◽  
Luciane Cruz Lopes ◽  
Caio Chaves Guimarães ◽  
Natalia Karol de Andrade ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Heart Rate ◽  
Adverse Effects ◽  
Herbal Medicines ◽  
Adult Patients ◽  
Anxiety Reduction ◽  
Dental Procedures ◽  
Oral Agents ◽  
Oral Sedation

ObjectivesIt can be challenging to manage patients who are anxious during dental procedures. There is a lack of evidence regarding the effectiveness and safety of oral sedation in adults. This study evaluated the effectiveness and safety of oral sedation in patients undergoing dental procedures.DesignSystematic review.MethodsRandomised clinical trials (RCTs) compared the oral use of benzodiazepines and other medications with a placebo or other oral agents in adult patients. A search of the Cochrane (CENTRAL), MEDLINE (via Ovid), EMBASE (via Ovid) and Cumulative Index to Nursing and Allied Health Literature (via Ovid) databases was conducted, without any restrictions on language or date of publication. The primary outcomes included the adverse effects and anxiety level. The secondary outcomes included sedation, satisfaction with the treatment, heart rate, respiratory rate, blood pressure and oxygen saturation. Reviewers, independently and in pairs, assessed each citation for eligibility, performed the data extraction and assessed the risk of bias. A narrative synthesis of the data was provided.ResultsA number of RCTs (n=327 patients) assessed the use of benzodiazepines (n=9) and herbal medicines (n=3). We found good satisfaction with treatment after the use of midazolam 7.5 mg or clonidine 150 µg and reduced anxiety with alprazolam (0.5 and 0.75 mg). Midazolam 15 mg promoted greater anxiety reduction than Passiflora incarnata L. 260 mg, while Valeriana officinalis 100 mg and Erythrina mulungu 500 mg were more effective than a placebo. More patients reported adverse effects with midazolam 15 mg. Diazepam 15 mg and V. officinalis 100 mg promoted less change in the heart rate and blood pressure than a placebo.ConclusionsGiven the limitations of the findings due to the quality of the included studies and the different comparisons made between interventions, further RCTs are required to confirm the effectiveness and safety of oral sedation in dentistry.PROSPERO registration numberCRD42017057142.

scholarly journals Effectiveness and safety of oral sedation in adult patients undergoing dental procedures: protocol for a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e017681 ◽  
Author(s):  
Jimmy de Oliveira Araújo ◽  
Rogério Heládio Lopes Motta ◽  
Cristiane de Cássia Bergamaschi ◽  
Caio Chaves Guimarães ◽  
Juliana Cama Ramacciato ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adult Patients ◽  
Dental Procedures ◽  
Oral Sedation

The effect of red pepper/capsaicin on blood pressure and heart rate: A systematic review and meta‐analysis of clinical trials

2021 ◽  
Author(s):  
Fatemeh Shirani ◽  
Sahar Foshati ◽  
Mohammad Tavassoly ◽  
Cain C. T. Clark ◽  
Mohammad Hossein Rouhani
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Heart Rate ◽  
Clinical Trials ◽  
Meta Analysis ◽  
Red Pepper

scholarly journals Absence of Adverse Effects of Tiotropium/Olodaterol Compared with the Monocomponents on Long-Term Heart Rate and Blood Pressure in Patients with Moderate-to-Very-Severe COPD

2020 ◽  
Vol Volume 15 ◽  
pp. 1935-1944
Author(s):  
Stefan Andreas ◽  
Lorcan McGarvey ◽  
Ulrich Bothner ◽  
Matthias Trampisch ◽  
Alberto de la Hoz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Adverse Effects ◽  
Severe Copd

Oral Agents in the Management of Urticaria: Patient Perception of Effectiveness and Level of Satisfaction with Treatment

1993 ◽  
Vol 27 (6) ◽  
pp. 730-731 ◽  
Author(s):  
Martin J. Pontasch ◽  
Lynn J. White ◽  
John C. Bradford
Keyword(s):  
Adverse Effects ◽  
Patient Perception ◽  
Cromolyn Sodium ◽  
Adult Patients ◽  
Teaching Hospitals ◽  
Acute Urticaria ◽  
Oral Agents ◽  
Satisfaction With Treatment ◽  
One Year ◽  
Lost To Follow Up

OBJECTIVE: Orally administered diphenhydramine, famotidine, and cromolyn sodium were compared for their abilities to alleviate symptoms of acute urticaria. DESIGN AND SETTING: This was a prospective, randomized, blind study, implemented in the emergency departments (EDs) of two teaching hospitals, each with an annual average of 40000 ED patient visits. Patient perception of the effectiveness of treatment was assessed using a visual analog scale. PATIENTS: 33 adult patients presenting to the EDs were entered into the study over a one-year period. Of these, 8 were lost to follow-up and 5 were noncompliant with medications and not included in data analysis. Twenty adult patients, aged 19–78 years, completed the five-day study: 7 received diphenhydramine, 6 received famotidine, and 7 received cromolyn sodium. RESULTS: Patients receiving diphenhydramine reported the greatest satisfaction with treatment: 86 percent (6/7) indicated they would use the medication again. Fifty percent (3/6) in the famotidine group and 43 percent (3/7) in the cromolyn sodium group rated the treatment as worth using again. Patients receiving famotidine reported the greatest occurrence of adverse effects (50 percent, 3/6); the lowest incidence of such effects was seen in the cromolyn sodium group (14 percent, 1/7). Patients receiving diphenhydramine reported adverse effects at a rate of 43 percent (3/7). CONCLUSIONS: Our results suggest that patients receiving diphenhydramine are more satisfied with their treatment than are patients receiving famotidine or cromolyn sodium.

Oral Antihypertensives for Hypertensive Urgencies

1994 ◽  
Vol 28 (3) ◽  
pp. 352-358 ◽  
Author(s):  
Mark A. Gales
Keyword(s):  
Blood Pressure ◽  
Adverse Effects ◽  
Antihypertensive Agents ◽  
Lower Blood Pressure ◽  
Blood Pressure Lowering ◽  
Oral Agents ◽  
Lower Blood ◽  
Pressure Lowering ◽  
Hypertensive Urgencies ◽  
Comparative Trials

OBJECTIVE: To review the data describing the use of oral antihypertensive agents in the treatment of hypertensive urgencies (HU). DATA SOURCES: A MEDLINE search of the English-language literature and fan searches of papers evaluating oral antihypertensives in HUs and emergencies were conducted. STUDY SELECTION: Controlled and uncontrolled studies in humans are reviewed. Emphasis was placed on recent trials evaluating individual agents and comparative trials. DATA SYNTHESIS: Comparative trials have demonstrated that four currently available oral agents can lower blood pressure rapidly and predictably. Nifedipine, the most extensively studied, and clonidine have served traditionally as the oral agents of choice for the treatment of HUs. All the agents can lower blood pressure effectively within the first few hours after dosing, but their use also has been associated with adverse effects. Nifedipine and captopril are the two agents with the most rapid onset, within 0.5–1 hour, and may treat hypertensive emergencies as well as urgencies. Clonidine and labetalol have maximal blood pressure lowering effects at 2–4 hours. CONCLUSIONS: Captopril, clonidine, labetalol, and nifedipine are all effective agents for the treatment of HUs. Agent selection should be based on the perceived need for urgent blood pressure control, the cause of HU, and concomitant conditions. A definite benefit from acute blood pressure lowering in HUs has yet to be demonstrated, especially in asymptomatic patients. More controlled trials with less aggressive dosing regimens and placebo controls need to be performed to assess the most appropriate treatments for HUs with the fewest adverse effects.

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