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Zalpelon was compared with triazolam for oral sedation in a third molar surgery model using a double-blind crossover design. Factors such as anxiolysis, amnesia, and quality of sedation were assessed. Of the 14 participants who completed the study, zaleplon sedation was found to be similar to triazolam sedation in all regards except that recovery from zaleplon was more rapid.
Key Words: Zaleplon; Triazolam; Oral sedation; Third molar surgery; Anxiolysis; Amnesia.
Because of the large number of patients who are anxious regarding dental or oral surgical treatment, dentists have developed a range of techniques to provide anxiolysis and/or sedation for procedures that they perform. The most common forms of sedation in the dental office are nitrous oxide-oxygen inhalation sedation, or oral sedation with benzodiazepines.
Triazolam (Halcion), a benzodiazepine derivative, is a sedative-hypnotic drug with a short half-life that causes little residual central nervous system depression (ie, drowsiness or "hangover"). Off label, triazolam has shown great utility as an anxiolytic-sedative for dental procedures. Orally administered triazolam, 0.5 mg, with 50% nitrous oxide in oxygen produces anxiolytic activity during oral surgery, which is comparable, on average, to 19 mg of intravenous diazepam.1 Peak plasma levels of orally administered triazolam are generally reached within 2 hours after oral administration, with clinical sedative effects realized in as quickly as 30 minutes.2 Additionally, triazolam has a short beta half-life, with a reported range of 1.5 to 5.5 hours, with no active metabolites.3 However, common adverse effects of triazolam may be undesirable for some patients. Ordinarily, these are extensions of desirable effects for which the drug was originally prescribed. These adverse effects occur more commonly later in the day after the dental appointment but may extend to the following day and include morning drowsiness, dizziness, nervousness or irritability, and impaired coordination. More serious adverse effects may occur but are more common with repeated doses and accumulation of the drug.4 These effects include significant memory impairment, abnormal thinking or behavior, confusion, anxiety, and depression.
Zaleplon (Sonata) is a short-acting, nonbenzodiazepine γ-aminobutyric acid A (GABA^sub A^) agonist hypnotic, which has no active metabolites. It has proven to be effective in the treatment of patients with sleep disorders by presenting less residual central nervous system or "hangover" effects, which are seen in patients...