Administration of oral midazolam in surgical dentistry

Abstract

AbstractObjectives: Many patients experience fear, anxiety and strain during dento‐alveolar surgeries which aggravate more complex procedures such as fixation of implants, difficult extractions. Many studies have in the past presented and assessed different methods of conscious sedation on patients who suffer from anxiety and fear. Primary aims of this retrospective study were to assess the suitability of using oral midazolam in surgical dentistry on patients with anxiety and to present a guideline on the required dosage of oral midazolam in order to achieve good, subjective conscious sedation. Our hypothesis is that oral midazolam is a safe and efficient conscious sedation method with few complications and side effects that can be administered on patients with anxiety during dento‐alveolar surgeries or those who find long surgical procedures challenging.Material and methods: This study is retrospective, and the method was applied to 1549 patients who were sedated with oral midazolam. This study was performed for 14 years (1989–2003), of which the majority were treated for dental implants and surgical extractions. For each patient, the following was documented: gender, age, patient's weight, surgical procedure, total dosage, dosage/kg, time between administration and operation, effect of sedation, and complications and awakening time after the procedure.Results: Patients experienced a positive and relaxed surgical session after being sedated with oral midazolam. The sedative effect was good in most of the cases except 152 (9, 8%), where an additional dosage was given. All of those who required an additional dose did achieve a good subjective conscious sedation after one additional dose. The additional dose was calculated as 50% of the original administered dose.Conclusion: The sedative effect of oral midazolam was found effective in this study and patients described the course of treatment positive and relaxing. Using midazolam as conscious sedation for dento‐alveolar surgeries on patients with fear and anxiety is a feasible, easily administered and efficient method with low‐rate complications. This study has presented a figure as a guideline for the recommended dose of oral midazolam based on patient's age and weight to achieve a good, subjective conscious sedation. On few occasions, an additional dose has been required if a subjective, good conscious sedation has not been accomplished. The additional dose in this study has been 50% of the original dose. The findings in this study indicate that using oral midazolam is efficacious in inducing conscious sedation in dentistry.