continuing education Table 2: Definition of general anesthesia and levels of sedation/analgesia Minimal sedation (anxiolysis) Moderate sedation/ analgesia (conscious sedation) Deep sedation/ analgesia General anesthesia Responsiveness Normal response to verbal stimulation. Purposeful response to verbal or tactile stimulation. Purposeful response following repeated or painful stimulation. Not arousable, even with painful stimulus. Airway Unaffected. No intervention required. Intervention may be required. Intervention often required. Spontaneous ventilation Unaffected. Adequate. May be inadequate. Frequently inadequate. Cardiovascular function Unaffected. Usually maintained. Usually maintained. May be impaired. anesthesia.12 Literature suggests that mild to moderate anxiety should be managed by minimal sedation using oral benzodiazepines,13 while moderate to severe anxiety should be handled by intravenous, intramuscular or oral benzodiazepines to obtain conscious sedation.14 Managing the other types of anxiety requires deep or general anesthesia with the ability to maintain ventilatory and cardiovascular functions. Triazolam Triazolam is one of the most commonly used pretreatment medications in dentistry. A hypnotic benzodiazepine, it has a very short elimination half-life, reported to vary between 1½ and 5½ hours. Triazolam is considered an intermediate-onset-of-action medication, with a peak onset that ranges from 45 minutes to 2 hours. Triazolam offers ease of use and has no active metabolites to consider for dosing and termination of action.15 80 JANUARY 2020 // dentaltown.comhttp://www.dentaltown.com