Think Before You Administer: Is Routine Benzodiazepine Premedication Before Endoscopy in Adults Necessary?

New hybrids based on benzimidazole and diazepine moieties: design, synthesis, characterization, molecular docking studies and their in vitro interactions with benzodiazepine receptors

Benzodiazepines are one of the most widely prescribed pharmacologic agents in the world. They are employed for numerous indications, including anxiety, insomnia, muscle relaxation, relief from spasticity caused by central nervous system pathology and epilepsy. In this work, we have synthesized some new hybrids based on benzimidazole and diazepine scaffolds from the reaction of suitable benzimidazole derivatives with glycine. NMR spectra, IR and mass as well as elemental analyses approved the structure of the title compounds. In vitro interactions of the title compounds were also examined on recombinant benzodiazepine receptors (αxβ2/3γ2, x = 1-3, 5) expressed in HEK293 cells. The results indicated that the title compounds exhibited suitable affinity for α1β2 γ2 subtype (Ki = 16-29 nM). To achieve deeper insight into their interactions with benzodiazepine receptors, molecular dynamics simulation was employed. According to the results obtained from the molecular dynamics simulation, Pro85, Leu103, Pro101, Gln102, Ile79, Ser80, Pro17, Leu82 and Val84 interact with the most potent ligand by hydrophobic interactions and Asp86 and Leu87 interact with the ligand by hydrogen bond interactions.Communicated by Ramaswamy H. Sarma.

Sedation-analgesia techniques for nonoperating room anesthesia: an update

PURPOSE OF REVIEW

There has been a substantial increase in nonoperating room anesthesia procedures over the years along with an increase in the complexity and severity of cases. These procedures pose unique challenges for anesthesia providers requiring meticulous planning and attention to detail. Advancements in the delivery of sedation and analgesia in this setting will help anesthesia providers navigate these challenges and improve patient safety and outcomes.

RECENT FINDINGS

There has been a renewed interest in the development of newer sedative and analgesic drugs and delivery systems that can safely provide anesthesia care in challenging situations and circumstances.

SUMMARY

Delivery of anesthesia care in nonoperating room locations is associated with significant challenges. The advent of sedative and analgesic drugs that can be safely used in situations where monitoring capabilities are limited in conjunction with delivery systems, that can incorporate unique patient characteristics and ensure the safe delivery of these drugs, has the potential to improve patient safety and outcomes. Further research is needed in these areas to develop newer drugs and delivery systems.