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Effects of antipsychotics on intravenous sedation with midazolam and propofol during dental treatment for patients with intellectual disabilities.

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Title: Effects of antipsychotics on intravenous sedation with midazolam and propofol during dental treatment for patients with intellectual disabilities.
Authors: Oda, Y., Yoshida, K., Kawano, R., Yoshinaka, T., Oda, A., Takahashi, T., Oue, K., Mukai, A., Irifune, M., Okada, Y.
Source: Journal of Intellectual Disability Research. Apr2022, Vol. 66 Issue 4, p323-331. 9p. 4 Charts.
Subjects: Propofol, Blood pressure, Anesthesia, Intravenous therapy, Cardiovascular system physiology, Clinical trials, Oral drug administration, Dental care, Treatment effectiveness, Drug interactions, Descriptive statistics, Heart beat, People with intellectual disabilities, Midazolam, Antipsychotic agents
Abstract: Background: Some patients with intellectual disabilities (ID) are prescribed antipsychotic drugs for symptomatic treatment of behavioural disorders. Nevertheless, it can still prove difficult to perform dental treatments safely for some patients with ID. In such cases, treatment under intravenous sedation (IVS) is one option. Sedative, hypnotic and α‐blocking effects of antipsychotic drugs may cause adverse events, such as severe hypotension, among patients who take antipsychotic drugs regularly. This study aimed to investigate the effects of oral antipsychotic medication on cardiovascular function during IVS. Accordingly, we compared mean blood pressure (MBP) and heart rate (HR) between patients who regularly take antipsychotic drugs and patients who do not. Methods: Thirty‐seven patients with ID were enrolled in this study. All participants were outpatients of Special Care Dentistry of general hospital and received dental treatment under IVS performed with a combination of midazolam and propofol. Eighteen patients regularly took antipsychotics (medication group), and 19 patients were not currently taking antipsychotics (non‐medication group). MBP, HR, dose, and effect‐site concentration of intravenous sedative medications were measured at three points: 'before IVS', 'at optimal sedation', and 'during dental treatment'. Results: The magnitude of reduction of MBP was significantly smaller in the medication group than in the non‐medication group (P < 0.023). However, there were no differences in MBP, HR, dose, and effect‐site concentration of midazolam and propofol between groups at any point. Conclusion: These results suggest that antipsychotic medication may not have clinically significant adverse effects on cardiovascular fluctuations during dental treatment under IVS for persons with ID. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Intellectual Disability Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Effects of antipsychotics on intravenous sedation with midazolam and propofol during dental treatment for patients with intellectual disabilities.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Oda%2C+Y%2E%22&quot;&gt;Oda, Y.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Yoshida%2C+K%2E%22&quot;&gt;Yoshida, K.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kawano%2C+R%2E%22&quot;&gt;Kawano, R.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Yoshinaka%2C+T%2E%22&quot;&gt;Yoshinaka, T.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Oda%2C+A%2E%22&quot;&gt;Oda, A.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Takahashi%2C+T%2E%22&quot;&gt;Takahashi, T.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Oue%2C+K%2E%22&quot;&gt;Oue, K.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mukai%2C+A%2E%22&quot;&gt;Mukai, A.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Irifune%2C+M%2E%22&quot;&gt;Irifune, M.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Okada%2C+Y%2E%22&quot;&gt;Okada, Y.&lt;/searchLink&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Journal+of+Intellectual+Disability+Research%22&quot;&gt;Journal of Intellectual Disability Research&lt;/searchLink&gt;. Apr2022, Vol. 66 Issue 4, p323-331. 9p. 4 Charts.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Propofol%22&quot;&gt;Propofol&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Blood+pressure%22&quot;&gt;Blood pressure&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Anesthesia%22&quot;&gt;Anesthesia&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Intravenous+therapy%22&quot;&gt;Intravenous therapy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cardiovascular+system+physiology%22&quot;&gt;Cardiovascular system physiology&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Clinical+trials%22&quot;&gt;Clinical trials&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Oral+drug+administration%22&quot;&gt;Oral drug administration&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Dental+care%22&quot;&gt;Dental care&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Treatment+effectiveness%22&quot;&gt;Treatment effectiveness&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Drug+interactions%22&quot;&gt;Drug interactions&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Descriptive+statistics%22&quot;&gt;Descriptive statistics&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Heart+beat%22&quot;&gt;Heart beat&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22People+with+intellectual+disabilities%22&quot;&gt;People with intellectual disabilities&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Midazolam%22&quot;&gt;Midazolam&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Antipsychotic+agents%22&quot;&gt;Antipsychotic agents&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Some patients with intellectual disabilities (ID) are prescribed antipsychotic drugs for symptomatic treatment of behavioural disorders. Nevertheless, it can still prove difficult to perform dental treatments safely for some patients with ID. In such cases, treatment under intravenous sedation (IVS) is one option. Sedative, hypnotic and α‐blocking effects of antipsychotic drugs may cause adverse events, such as severe hypotension, among patients who take antipsychotic drugs regularly. This study aimed to investigate the effects of oral antipsychotic medication on cardiovascular function during IVS. Accordingly, we compared mean blood pressure (MBP) and heart rate (HR) between patients who regularly take antipsychotic drugs and patients who do not. Methods: Thirty‐seven patients with ID were enrolled in this study. All participants were outpatients of Special Care Dentistry of general hospital and received dental treatment under IVS performed with a combination of midazolam and propofol. Eighteen patients regularly took antipsychotics (medication group), and 19 patients were not currently taking antipsychotics (non‐medication group). MBP, HR, dose, and effect‐site concentration of intravenous sedative medications were measured at three points: &#39;before IVS&#39;, &#39;at optimal sedation&#39;, and &#39;during dental treatment&#39;. Results: The magnitude of reduction of MBP was significantly smaller in the medication group than in the non‐medication group (P &lt; 0.023). However, there were no differences in MBP, HR, dose, and effect‐site concentration of midazolam and propofol between groups at any point. Conclusion: These results suggest that antipsychotic medication may not have clinically significant adverse effects on cardiovascular fluctuations during dental treatment under IVS for persons with ID. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of Journal of Intellectual Disability Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/jir.12913
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 9
        StartPage: 323
    Subjects:
      – SubjectFull: Propofol
        Type: general
      – SubjectFull: Blood pressure
        Type: general
      – SubjectFull: Anesthesia
        Type: general
      – SubjectFull: Intravenous therapy
        Type: general
      – SubjectFull: Cardiovascular system physiology
        Type: general
      – SubjectFull: Clinical trials
        Type: general
      – SubjectFull: Oral drug administration
        Type: general
      – SubjectFull: Dental care
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Drug interactions
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Heart beat
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      – SubjectFull: People with intellectual disabilities
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      – SubjectFull: Midazolam
        Type: general
      – SubjectFull: Antipsychotic agents
        Type: general
    Titles:
      – TitleFull: Effects of antipsychotics on intravenous sedation with midazolam and propofol during dental treatment for patients with intellectual disabilities.
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            – D: 01
              M: 04
              Text: Apr2022
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              Y: 2022
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