title: Anesthesia Complications of Diazepam Use for Adolescents Receiving Extraction of Third Molars.
abstract: OBJECTIVE
  To evaluate the safety of midazolam and diazepam for adolescents during third molar extraction and whether any differences in perioperative complications exist when using the 2 benzodiazepines alone or in combination.
  
  
  METHODS
  A prospective study was performed in adolescents (<21 yr old) who underwent at least 1 third molar extraction by an oral and maxillofacial surgeon in the ambulatory setting from January 2001 through December 2010 using the Oral and Maxillofacial Surgery Outcomes System. The primary predictor variable was type of benzodiazepine used, divided into the total number of patients who received diazepam with or without midazolam. The outcome of interest was adverse complications resulting from anesthesia. Multivariable logistic regression was applied to measure the association between benzodiazepine type and adverse complications.
  
  
  RESULTS
  Patients in the diazepam group (n = 4,213) and in the combination group (n = 426) had a complication rate of 1.4%, whereas those in the midazolam group (n = 13,451) had a complication rate of 1.0% (P = .027). Multiple logistic regression analysis showed a 50% increased odds of adverse complications in patients receiving diazepam (adjusted odds ratio = 1.50; 95% confidence interval, 1.05 to 2.16; P = .027).
  
  
  CONCLUSIONS
  Adolescent patients who received intravenous diazepam during third molar procedures had an increased odds of anesthesia-related complications compared with those given midazolam.
authors.affiliation: Postgraduate Year 1 Resident, Department of Oral and Maxillofacial Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA. Electronic address: gino.inverso@uphs.upenn.edu.
authors.forename: Gino
authors.initials: G
authors.lastname: Inverso
authors.affiliation: Attending Oral and Maxillofacial Surgeon, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA.
authors.forename: Cory M
authors.initials: CM
authors.lastname: Resnick
authors.affiliation: Senior Research Associate, American Association of Oral and Maxillofacial Surgeons, Rosemont, IL.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Gonzalez
authors.affiliation: Associate Professor, Harvard School of Dental Medicine; Director, Center for Applied Clinical Investigation, Massachusetts General Hospital, Boston, MA.
authors.forename: Sung-Kiang
authors.initials: SK
authors.lastname: Chuang
mesh_terms: D000293:Adolescent; D000766:Anesthesia, Dental / Q000009:adverse effects* / Q000379:methods; D018686:Anesthetics, Intravenous; D003975:Diazepam / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008874:Midazolam / Q000009:adverse effects; D008964:Molar, Third / Q000601:surgery*; D011446:Prospective Studies; D014081:Tooth Extraction / Q000379:methods*
chemical_list: D018686:Anesthetics, Intravenous; D003975:Diazepam; D008874:Midazolam