2009 Fiscal Year Final Research Report
Molecular genetic evaluation of the clinical effect of sedatives
| Project/Area Number |
20791559
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Surgical dentistry
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| Research Institution | Asahi University |
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Principal Investigator |
FUJIWARA Shigeki Asahi University, 歯学部・総合医科学講座・麻酔学分野, 助教 (90434505)
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| Project Period (FY) |
2008 – 2009
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| Keywords | 歯科麻酔学 |
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| Research Abstract |
Simultaneous injection of a local anesthetic and a sedative in the oral cavity to reduce and prevent complications associated with local anesthesia during dental treatment (e.g., hyperventilation syndrome and cerebral anemia symptoms) was first reported by Yoichi Kurasawa and his colleagues in 2000. However, there has been no detailed evidence regarding this anesthetic procedure. This year, we performed recording and analysis of vital signs following local injection of sedatives (mainly midazolam) in the oral cavity. Percutaneous arterial oxygen saturation, but not respiratory rate, heart rate or blood pressure, showed significant differences between the sedative and control groups. Plasma midazolam concentration reached the maximum level 5 minutes after injection (101.0 ± 31.1 ng/ml), and then decreased over time to an 80-minute value of 43.0 ± 14.5 ng/ml. BIS index as measured with a BIS monitor were significantly lower in the midazolam group than in the control group at the followin
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g time points: 10 (79.1 ± 4.7), 20 (64.6 ± 7.5), 30 (56.3 ± 15.0), 40 (58.1 ± 17.6), 60 (60.5 ± 24.6) and 80 (92.2 ± 5.8) minutes after infection. The minimum BIS index was recorded 30 minutes after injection. The demonstration of the detailed recording and analysis of blood concentrations and electroencephalographic changes was the most important achievement of the present study and should lead to the prevention of accidents and complications and the realization of safer dental treatment. The present results were presented at the 56th Annual Meeting of the Japan Society of Anesthesiologists (August 2009, Kobe, Japan). For the second research subject regarding differences in sedative effect related to the genomic DNA sequence, we purified DNA and analyzed for mutations in the GABAα6 receptor and cytochrome P450 3A subfamily genes using restriction fragment length polymorphism polymerase chain reaction; however, we have not found any significant correlation between these mutations and degree of sedation. We will continue to perform analyses to further clarify this. Less
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