Proceedings: The effect of age on plasma pethidine concentrations.
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Biomedical subjects
Publications and source records attributed to M D Vickers.
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Urinary metabolites before dental treatment were compared in a group of patients with dental phobia and in a matched control group. Plasma adrenaline, noradrenaline, and free fatty acids were estimated before treatment, immediately after sedation with diazapam 0.2 mg/kg body weight in the phobic patients, during induction of oral anaesthesia, and during and after surgery. Patients with dental phobia had significantly higher levels of adrenaline, which were only temporarily lowered by sedation, and which during treatment remained consistently higher than those of control patients.
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The physiological responses to intravenous diazepam and oral local analgesia for conservative dentistry have been assessed in 16 patients. Apart from a transient tachycardia during actual administration of the drug, no clinically significant changes occurred in the haemodynamic, respiratory, or metabolic status of the patients. In some patients there was a period of incompetence of the laryngeal closure reflex.
Patients unable to submit themselves to routine dental treatment under local anaesthesia were studied during treatment under diazepam sedation accompanied by local anaesthesia, and compared with a matched control group for psychiatric assessment. Physiological responses, operating conditions, amnesia, pain threshold, and recovery were all assessed by various tests.Some of the patients had an anxiety neurosis, and several had been referred because of previous failure to complete dental treatment. Satisfactory conditions were obtained in all but two instances, and no adverse physiological responses occurred with diazepam in an intravenous dose of 0.2 mg./kg. Patients were clinically safe to leave accompanied by a responsible adult within one hour of administration of the drug. Some patients showed an improvement in attitude towards dentistry following treatment.
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