[Evaluation of third molar surgery by patients choosing between local anaesthesia alone and with additional conscious...

This study was conducted on patients undergoing third molar surgery to evaluate their opinions on surgery and the follow-up period. Two groups were formed, as patients were able to choose between local anaesthesia alone or with additional conscious sedation by means of intravenous Midazolam.

A total of 426 patients ranging in age from 11 to 61 years (mean 20.8 years) participated, 335 of whom preferred Midazolam sedation (0.1 mg/kg) while 91 voted for local anaesthesia only. During the operation an impacted lower third molar was removed by osteotomy, and in 80% of these cases the upper third molar on the same side was also removed. A questionnaire on the operation, the follow-up period, postoperative pain and use of analgesics was distributed before the event.

Women and younger patients preferred conscious sedation. Surgery was described as significantly less distressing by the sedated group (diagram 1), whereas there was no difference in views of the follow-up period or postoperative pain. Patients in the Midazolam group took more analgesics on postoperative days 1-3. Nonsedated men tended to evaluate surgery as more distressing than women in the same group, while there were no sex differences in the Midazolam group.

Following the evaluation of surgery as more "pleasant" by sedated patients, it might be expected that this would contribute to a similar experience of the follow-up period. In this study, however no such connection was found. It is possible that preoperative self-selection of the patients (more sensitive and cautious persons preferred conscious sedation) might be responsible for these results.