![]() ![]() Giving the drug by this route requires more time to reach effective plasma levels as opposed to the intravenous route of administration. The problem with 0.2 mg SM/SL flumazenil administration is as follows. For instance, the sedated, unconscious patient with apnea, upper airway obstruction, or hypoventilation any of which could lead to debilitating injuries such as brain damage due to the lack of oxygen delivery. ![]() This agent should only be used in an overdose emergency situation that has become difficult or impossible to manage non-pharmacologically. Cautions to keep in mind with flumazenil use include eliciting a seizure in patients who control their seizures with benzodiazepines, and watching for patient resedation later due to the relatively short duration of action with flumazenil in relation to most benzodiazepines. It is supplied in a 0.1 mg/ml concentration only. The prescribed IV administration technique is to titrate slowly to arousal with 0.2 mg increments. Flumazenil is only approved for intravenous (IV) administration. It does so by competitively antagonizing the benzodiazepine at the receptor site level. Common benzodiazepines being used for these purposes are triazolam, lorazepam and diazepam.Īnother common technique taught with oral sedation using benzodiazepines is a pharmacological rescue technique using submucosal/sublingual (SM/SL) injections of flumazenil.įlumazenil reverses the effects of benzodiazepines. The effects are dose-dependent and have a long history of being used safely in the dental setting. Benzodiazepines are used to reduce anxiety, and to provide sedative effects, amnesia, muscle relaxation, and anti-convulsive effects. One of the more frequent ways for dentists to begin providing sedation procedures to their patients is through oral sedation.ĭentists are commonly taught to achieve mild or moderate sedation via oral sedation with the use of benzodiazepines. There are an ever-growing number of sedation courses being offered throughout Canada and the United States. Patients receiving the gamut of treatment procedures not just extensive surgical procedures are requesting sedation services.Ī number of organizations have listened to these requests and have answered them by providing sedation courses for dentists. Furthermore, this study demonstrated that these same fearful patients were requesting sedation services. According to Chanpong et al., in 2003 of Canadians, about 10% of the general population were somewhat afraid of dentistry, 5% had a high fear level, and many appointments were avoided or canceled in relation to these patients’ worries and fears of undergoing dental treatment. The need for sedation in dentistry is evident.
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