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Dexmedetomidine sedation with and without midazolam for third molar surgery
Megann K Smiley1, Simon R Prior
1Nationwide Children's Hospital, Columbus, Ohio, and.
Anesthesia Progress
|April 5, 2014
Summary
Adding midazolam to dexmedetomidine reduced early anxiety and improved psychomotor function in patients undergoing oral surgery. However, midazolam also caused amnesia and prolonged discharge, without increasing patient satisfaction.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Dexmedetomidine is used for sedation in outpatient procedures.
- Its sedative response can be unpredictable.
- Midazolam is a common alternative for sedation.
Purpose of the Study:
- To compare the effects of dexmedetomidine alone versus dexmedetomidine plus midazolam on patient anxiety, psychomotor performance, and satisfaction.
- To evaluate the amnesic effects and discharge times associated with the combined regimen.
Main Methods:
- Twenty-four patients were randomized into two groups.
- One group received continuous intravenous dexmedetomidine.
- The other group received continuous intravenous dexmedetomidine plus a small dose of midazolam.
Main Results:
- Patients receiving midazolam showed lower early anxiety and better psychomotor performance.
- An amnesic effect was observed in the midazolam group, but patient satisfaction was not improved.
- A prolonged discharge time was noted in patients who received midazolam.
Conclusions:
- While midazolam offers short-term benefits in anxiety and performance, it may lead to prolonged discharge.
- Dexmedetomidine alone demonstrated unpredictable sedation, potentially limiting its practicality for oral surgery.
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