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. 1987 Mar-Apr;34(2):37–42.

Evaluation of the Anxiolytic and Amnestic Effects of Diazepam and Midazolam for Minor Oral Surgery

Neil H Luyk, Mark A Boyle, R Peter Ward-Booth
PMCID: PMC2148574  PMID: 3474909

Abstract

Thirty three healthy patients (ASA 1) who required the removal of impacted third molars were included in a double-blind cross-over trial to compare the amnestic and anxiolytic efficacy of diazepam and midazolam. The anxiolytic properties of the two drugs were assessed objectively by the measurement of changes in blood pressure, pulse rate, plasma cortisol levels, and subjectively by a patient assessment using a visual analogue scale for anxiety. The amnestic properties were evaluated by patient's ability to recall two visual stimuli they were shown. The first drug given was titrated to clinical sedation and the second drug was given in an “equipotent” ratio of 1.0 midazolam to 2.86 diazepam. There was a statistically significant fall in anxiety and good levels of amnesia achieved using both drugs. No statistical differences were detected between the two drugs.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Al-Khudhairi D., Whitwam J. G., McCloy R. F. Midazolam and diazepam for gastroscopy. Anaesthesia. 1982 Oct;37(10):1002–1006. doi: 10.1111/j.1365-2044.1982.tb01712.x. [DOI] [PubMed] [Google Scholar]
  2. Aun C., Flynn P. J., Richards J., Major E. A comparison of midazolam and diazepam for intravenous sedation in dentistry. Anaesthesia. 1984 Jun;39(6):589–593. doi: 10.1111/j.1365-2044.1984.tb07370.x. [DOI] [PubMed] [Google Scholar]
  3. Barclay J. K., Hunter K. M., McMillan W. Midazolam and diazepam compared as sedatives for outpatient surgery under local analgesia. Oral Surg Oral Med Oral Pathol. 1985 Apr;59(4):349–355. doi: 10.1016/0030-4220(85)90056-8. [DOI] [PubMed] [Google Scholar]
  4. Berggren L., Eriksson I., Mollenholt P., Wickbom G. Sedation for fibreoptic gastroscopy: a comparative study of midazolam and diazepam. Br J Anaesth. 1983 Apr;55(4):289–296. doi: 10.1093/bja/55.4.289. [DOI] [PubMed] [Google Scholar]
  5. Boralessa H., Senior D. F., Whitwam J. G. Cardiovascular response to intubation. A comparative study of thiopentone and midazolam. Anaesthesia. 1983 Jul;38(7):623–627. doi: 10.1111/j.1365-2044.1983.tb12152.x. [DOI] [PubMed] [Google Scholar]
  6. Brown C. R., Sarnquist F. H., Canup C. A., Pedley T. A. Clinical, electroencephalographic, and pharmacokinetic studies of a water-soluble benzodiazepine, midazolam maleate. Anesthesiology. 1979 May;50(5):467–470. doi: 10.1097/00000542-197905000-00017. [DOI] [PubMed] [Google Scholar]
  7. Dionne R. A., Driscoll E. J., Butler D. P., Wirdzek P. R., Sweet J. P. Evaluation by thoracic impedance cardiography of diazepam, placebo, and two drug combinations for intravenous sedation of dental outpatients. J Oral Maxillofac Surg. 1983 Dec;41(12):782–788. doi: 10.1016/s0278-2391(83)80044-5. [DOI] [PubMed] [Google Scholar]
  8. Dixon J., Power S. J., Grundy E. M., Lumley J., Morgan M. Sedation for local anaesthesia. Comparison of intravenous midazolam and diazepam. Anaesthesia. 1984 Apr;39(4):372–376. doi: 10.1111/j.1365-2044.1984.tb07281.x. [DOI] [PubMed] [Google Scholar]
  9. Dixon R. A., Kenyon C., Marsh D. R., Thornton J. A. Midazolam in conservative dentistry. A cross-over trial. Anaesthesia. 1986 Mar;41(3):276–281. doi: 10.1111/j.1365-2044.1986.tb12788.x. [DOI] [PubMed] [Google Scholar]
  10. Dundee J. W., Wilson D. B. Amnesic action of midazolam. Anaesthesia. 1980 May;35(5):459–461. doi: 10.1111/j.1365-2044.1980.tb03822.x. [DOI] [PubMed] [Google Scholar]
  11. Gelfman S. S., Gracely R. H., Driscoll E. J., Wirdzek P. R., Sweet J. B., Butler D. P. Conscious sedation with intravenous drugs: a study of amnesia. J Oral Surg. 1978 Mar;36(3):191–197. [PubMed] [Google Scholar]
  12. Goldstein D. S., Dionne R., Sweet J., Gracely R., Brewer H. B., Jr, Gregg R., Keiser H. R. Circulatory, plasma catecholamine, cortisol, lipid, and psychological responses to a real-life stress (third molar extractions): effects of diazepam sedation and of inclusion of epinephrine with the local anesthetic. Psychosom Med. 1982 Jul;44(3):259–272. doi: 10.1097/00006842-198207000-00004. [DOI] [PubMed] [Google Scholar]
  13. Gram L. F., Christensen P. Benzodiazepine suppression of cortisol secretion: a measure of anxiolytic activity? Pharmacopsychiatry. 1986 Jan;19(1):19–22. doi: 10.1055/s-2007-1017143. [DOI] [PubMed] [Google Scholar]
  14. Greenblatt D. J., Shader R. I., Abernethy D. R. Drug therapy. Current status of benzodiazepines. N Engl J Med. 1983 Aug 11;309(6):354–358. doi: 10.1056/NEJM198308113090607. [DOI] [PubMed] [Google Scholar]
  15. Gregg J. M., Ryan D. E., Levin K. H. The amnesic actions of diazepam. J Oral Surg. 1974 Sep;32(9):651–664. [PubMed] [Google Scholar]
  16. Kanto J. H. Midazolam: the first water-soluble benzodiazepine. Pharmacology, pharmacokinetics and efficacy in insomnia and anesthesia. Pharmacotherapy. 1985 May-Jun;5(3):138–155. doi: 10.1002/j.1875-9114.1985.tb03411.x. [DOI] [PubMed] [Google Scholar]
  17. Kawar P., Carson I. W., Clarke R. S., Dundee J. W., Lyons S. M. Haemodynamic changes during induction of anaesthesia with midazolam and diazepam (Valium) in patients undergoing coronary artery bypass surgery. Anaesthesia. 1985 Aug;40(8):767–771. doi: 10.1111/j.1365-2044.1985.tb11002.x. [DOI] [PubMed] [Google Scholar]
  18. Korttila K., Linnoila M. Recovery and skills related to driving after intravenous sedation: dose-response relationship with diazepam. Br J Anaesth. 1975 Apr;47(4):457–463. doi: 10.1093/bja/47.4.457. [DOI] [PubMed] [Google Scholar]
  19. Korttila K., Tarkkanen J. Comparison of diazepam and midazolam for sedation during local anaesthesia for bronchoscopy. Br J Anaesth. 1985 Jun;57(6):581–586. doi: 10.1093/bja/57.6.581. [DOI] [PubMed] [Google Scholar]
  20. Lebowitz P. W., Cote M. E., Daniels A. L., Ramsey F. M., Martyn J. A., Teplick R. S., Davison J. K. Comparative cardiovascular effects of midazolam and thiopental in healthy patients. Anesth Analg. 1982 Sep;61(9):771–775. [PubMed] [Google Scholar]
  21. Lundgren S. Comparison of rectal diazepam and subcutaneous morphine-scopolamine administration for outpatient sedation in minor oral surgery. Acta Anaesthesiol Scand. 1985 Oct;29(7):674–678. doi: 10.1111/j.1399-6576.1985.tb02279.x. [DOI] [PubMed] [Google Scholar]
  22. Magni V. C., Frost R. A., Leung J. W., Cotton P. B. A randomized comparison of midazolam and diazepam for sedation in upper gastrointestinal endoscopy. Br J Anaesth. 1983 Nov;55(11):1095–1101. doi: 10.1093/bja/55.11.1095. [DOI] [PubMed] [Google Scholar]
  23. McClure J. H., Brown D. T., Wildsmith J. A. Comparison of the i.v. administration of midazolam and diazepam as sedation during spinal anaesthesia. Br J Anaesth. 1983 Nov;55(11):1089–1093. doi: 10.1093/bja/55.11.1089. [DOI] [PubMed] [Google Scholar]
  24. McGimpsey J. G., Kawar P., Gamble J. A., Browne E. S., Dundee J. W. Midazolam in dentistry. Br Dent J. 1983 Jul 23;155(2):47–50. doi: 10.1038/sj.bdj.4805120. [DOI] [PubMed] [Google Scholar]
  25. Norris W. The quantitative assessment of premedication. Br J Anaesth. 1969 Sep;41(9):778–784. doi: 10.1093/bja/41.9.778. [DOI] [PubMed] [Google Scholar]
  26. Pinnock C. A., Fell D., Hunt P. C., Miller R., Smith G. A comparison of triazolam and diazepam as premedication agents for minor gynaecological surgery. Anaesthesia. 1985 Apr;40(4):324–328. doi: 10.1111/j.1365-2044.1985.tb10784.x. [DOI] [PubMed] [Google Scholar]
  27. Reves J. G., Samuelson P. N., Lewis S. Midazolam maleate induction in patients with ischaemic heart disease: haemodynamic observations. Can Anaesth Soc J. 1979 Sep;26(5):402–409. doi: 10.1007/BF03006455. [DOI] [PubMed] [Google Scholar]
  28. SHANNON I. L., ISBELL G. M., PRIGMORE J. R., HESTER W. R. Stress in dental patients. II. The serum free 17-hydroxycorticosteroid response in routinely appointed patients undergoing simple exodontia. Oral Surg Oral Med Oral Pathol. 1962 Sep;15:1142–1146. doi: 10.1016/0030-4220(62)90317-1. [DOI] [PubMed] [Google Scholar]
  29. Seymour R. A., Meechan J. G., Blair G. S. An investigation into post-operative pain after third molar surgery under local analgesia. Br J Oral Maxillofac Surg. 1985 Dec;23(6):410–418. doi: 10.1016/0266-4356(85)90025-7. [DOI] [PubMed] [Google Scholar]
  30. Summers L. An investigation into the effects of surgical stress on the fit and poor-risk patient including the modifying effect of relative analgesia and beta-blockade. Part I. The effects of surgical stress on fit and poor-risk patients. Br J Oral Surg. 1981 Mar;19(1):3–12. doi: 10.1016/0007-117x(81)90015-9. [DOI] [PubMed] [Google Scholar]
  31. Whitwam J. G., Al-Khudhairi D., McCloy R. F. Comparison of midazolam and diazepam in doses of comparable potency during gastroscopy. Br J Anaesth. 1983 Aug;55(8):773–777. doi: 10.1093/bja/55.8.773. [DOI] [PubMed] [Google Scholar]
  32. Wickstrøm E., Allgulander C. Comparison of quazepam, flunitrazepam and placebo as single-dose hypnotics before surgery. Eur J Clin Pharmacol. 1983;24(1):67–69. doi: 10.1007/BF00613929. [DOI] [PubMed] [Google Scholar]

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