Effects of intravenous midazolam and diazepam on patient response, percentage of oxygen saturation, and hemodynamic factors during periodontal surgery.
BACKGROUND
The purpose of this double-masked study was to evaluate effects of intravenous sedation (IVS) using midazolam or diazepam during periodontal procedures on patient recall, psychomotor response, oxygen saturation, and hemodynamic factors.


METHODS
Seventeen patients received either two or three scheduled periodontal surgeries under IVS with midazolam, diazepam, or placebo control. Patients were monitored throughout the procedure for hemodynamic variables, percent oxygen saturation, level of recall of common objects presented at baseline, and psychomotor function via the perceptual speed test (PST).


RESULTS
Fifteen patients completed the study with average titrated dosages of 3.3 and 12.1 mg for midazolam and diazepam, respectively. Within the limitations of the study, there were few differences observed between the drugs with regard to hemodynamic variables, oxygen saturation, and overall percentage of objects recalled by patients sedated with either drug. However, midazolam was found to cause a greater incidence of amnesia lasting up to 30 minutes when compared to placebo. Patients on diazepam required an average of 15 minutes longer to recover accuracy as measured by the PST.


CONCLUSIONS
The results suggest that diazepam and midazolam each may have advantages for IVS. In procedures lasting over 45 minutes, diazepam appears to be more clinically advantageous including a wider margin of safety during titration and gradual recovery. Midazolam may be used for shorter procedures for faster onset of action, predictable amnesic effects, and relatively rapid recovery.
Staretz
Lauri R
LR
West Los Angeles Veterans Affairs (Wadsworth VA) Medical Center, Section of Periodontics, Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.
Otomo-Corgel
Joan
J
Lin
James I
JI
D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental; D001794:Blood Pressure / Q000187:drug effects*; D016292:Procedural Sedation; D018592:Cross-Over Studies; D003975:Diazepam / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007275:Injections, Intravenous; D008297:Male; D011939:Mental Recall / Q000187:drug effects; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D010510:Periodontal Diseases / Q000601:surgery*; D010919:Placebos; D011597:Psychomotor Performance / Q000187:drug effects; D013997:Time Factors
D006993:Hypnotics and Sedatives; D010919:Placebos; D003975:Diazepam; D008874:Midazolam; D010100:Oxygen