A comparison of oral and intravenous diazepam sedation for periodontal surgery

Intravenous and oral diazepam were evaluated as to their effectiveness in conscious sedation during two similar surgical episodes. Ten patients, six females and four males, from 30 to 60 years of age were included in the study. Patients received either 10 mg oral diazepam and saline intravenous injection or oral placebo and 10 mg intravenous (IV) diazepam at each trial. Half the patients received the oral diazepam first and the other half received the IV diazepam first. Patients were not informed as to the route of administration during each trial. Physiologic stress was measured by monitoring blood pressure, heart rate, skin temperature, galvanic skin response, and plasma catecholamine levels. Patients evaluated their comfort and nervousness levels on a questionnaire. Anterograde amnesia was tested by patient's ability to recall objects shown them during the procedure. As evidenced by the physiologic and biochemical parameters, intravenous diazepam was more effective in reducing anxiety and stress as compared with an equivalent oral dose. Patients' subjective ratings were consistent with these findings. Intravenous diazepam was effective in producing anterograde amnesia in the majority of patients, whereas no amnesic effect was noted with oral diazepam. Correlation statistics demonstrated a relative independence of the parameters measured in the present study indicating that all parameters must be considered in overall patient evaluation. Reduction of anxiety during the first surgery resulted in less anxiety on the subsequent visit.