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Related Experiment Videos

Patient-controlled sedation using remifentanil for third molar extraction.

C C Y Fong1, A Kwan

  • 1Department of Anaesthesia, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong.

Anaesthesia and Intensive Care
|June 17, 2005
PubMed
Summary

Patient-controlled sedation with remifentanil did not improve pain management for dental extractions. This study found no significant benefits compared to local anesthesia alone, despite appearing safe.

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Area of Science:

  • Anesthesiology
  • Oral Surgery

Background:

  • Effective pain management is crucial for outpatient dental procedures.
  • Local anesthesia is standard for dental extractions, but adjuncts are sometimes used.

Purpose of the Study:

  • To evaluate patient-controlled sedation (PCS) with remifentanil as an adjunct to local anesthesia for third molar extraction pain.
  • To assess the safety and efficacy of this sedation technique during monitored anesthetic care.

Main Methods:

  • A randomized controlled trial involving 40 adult Chinese patients undergoing outpatient third molar extraction.
  • Patients were assigned to receive either remifentanil (RG) or saline (CG) via PCS, alongside local anesthesia.
  • Pain scores, anxiety levels, vital signs, and complications were monitored.

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Main Results:

  • Both groups showed high variability in patient-controlled sedation demands and consumption.
  • No rescue local anesthetic or midazolam was required in either group.
  • No significant differences were observed in pain scores, anxiety, vital signs, or major complications between the remifentanil and saline groups.

Conclusions:

  • Patient-controlled remifentanil sedation appears safe for outpatient third molar extractions.
  • However, it did not provide additional pain relief or anxiety reduction compared to local anesthesia alone.
  • The addition of patient-controlled remifentanil was not found to be a useful adjunct in this context.