Oral midazolam sedation in third molar surgery

Area of Science:

• Oral and Maxillofacial Surgery
• Pharmacology
• Anesthesiology

Background:

• Minor oral surgery, such as third molar extraction, can cause patient anxiety.
• Oral sedation is an option to supplement local anesthesia for managing anxiety during dental procedures.

Purpose of the Study:

• To evaluate the efficacy and patient acceptance of oral midazolam as a sedative agent for minor oral surgery.
• To compare oral midazolam with a placebo in patients undergoing bilateral lower third molar extractions.

Main Methods:

• A double-blind, randomized, placebo-controlled study involving 30 healthy young adults.
• Participants received either oral midazolam or placebo 45 minutes before surgery on two separate visits for bilateral third molar removal.
• Outcomes assessed included patient relaxation, amnesia, sedation duration, operating conditions, vital signs, and adverse effects.

Main Results:

• The majority of patients receiving midazolam reported relaxation during the procedure.
• Approximately 75% of patients experienced partial to complete amnesia.
• Midazolam provided sedation for about 45 minutes, ensuring good operating conditions and stable vital signs.
• Common adverse effects were transient drowsiness and dizziness.

Conclusions:

• Oral midazolam is a valuable adjunct to local anesthesia for minor oral surgery, improving patient comfort and surgical conditions.
• Most patients preferred oral midazolam sedation and expressed willingness to use it for future procedures.
• Patient awareness of oral sedation options for dental procedures was limited.