Comparison of dexmedetomidine and midazolam for conscious sedation in dental surgery monitored by bispectral index.
Although various sedative drugs in different regimens and given by different delivery routes have been used for conscious sedation, the ideal agent and regimen remain to be established. This study was designed to compare the efficacy (sedation, anxiolysis, analgesia, operating conditions, and patients' satisfaction) and safety of midazolam and dexmedetomidine as sedatives for dental procedures in a randomised, double-blind study in third molar and dental implant surgery. Sixty healthy patients who were American Society of Anesthesiologists (ASA) group I or II were enrolled and we recorded their personal details, the amount of drug used, their degree of satisfaction, duration of operation, and haemodynamic and respiratory variables. The two groups were comparable. The amount of local anaesthetic (p=0.11) and the duration of operation did not differ significantly (p=0.32). The patients in the dexmedetomidine group had a slower heart rate, lower systolic and diastolic pressure, and cooperated better. There were no significant differences in their respiratory rates, bispectral index, and total volume of drugs used. We conclude that dexmedetomidine works as well as midazolam for outpatient dental procedures and can be used as an alternative to midazolam.
Department of Oral and Maxillofacial Surgery, National University Singapore, Singapore.
Tai Weng Victor
TW
Fan
Lian Kah
LK
Ti
Intekhab
I
Islam
D000328:Adult; D000556:Ambulatory Surgical Procedures; D000698:Analgesia; D000766:Anesthesia, Dental / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects; D016292:Procedural Sedation / Q000379:methods*; D056805:Consciousness Monitors; D003299:Cooperative Behavior; D016854:Dental Anxiety / Q000517:prevention & control; D003758:Dental Implantation, Endosseous; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D008964:Molar, Third / Q000601:surgery; D016343:Monitoring, Intraoperative / Q000295:instrumentation; D061646:Operative Time; D019647:Oral Surgical Procedures; D017060:Patient Satisfaction; D011446:Prospective Studies; D012119:Respiration / Q000187:drug effects; D012449:Safety; D016896:Treatment Outcome
D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D008874:Midazolam