title: A retrospective audit to evaluate the effect of the change in midazolam concentration from 10 mg/5 ml to 5 mg/5 ml ampoules on midazolam doses given to sedation patients following the rapid response report (RRR).
abstract: The technique of intravenous sedation with a benzodiazepine is a well documented and successful method for reducing fear and anxiety in many patients who regard dental treatment as challenging and potentially painful. One of the most important factors to achieving a well sedated patient is ensuring the dose of the drug given is titrated to the individual patient. Five years ago, a Rapid Response Report issued by the National Patient Safety Agency changed the concentration of midazolam within a 5 ml ampoule from 10 mg/5 ml to 5 mg/5 ml. A retrospective audit of 300 patients undergoing oral surgery treatment under intravenous midazolam sedation at Birmingham Dental Hospital was carried out over a 6-month period to assess whether this difference in midazolam concentration had any influence on the average dose of midazolam given to these patients.
  
  
  METHODS
  The midazolam doses given by five clinicians were audited both before and after the concentration change.
  
  
  RESULTS
  the mean midazolam dose that was administered by three clinicians decreased following the change in concentration. In addition, the number of patients given greater than 5 mg midazolam following the change decreased with all five clinicians.
  
  
  CONCLUSIONS
  The change in midazolam concentration from 10 mg/5 ml to 5 mg/5 ml ampoules has resulted in the overall average dose of midazolam given by five clinicians at Birmingham Dental Hospital to decrease.
authors.affiliation: Birmingham Dental Hospital, St Chad's Queensway, Birmingham B4 6NN.
authors.forename: Shazia
authors.initials: S
authors.lastname: Kaka
authors.forename: Pan
authors.initials: P
authors.lastname: Taneja
mesh_terms: D000766:Anesthesia, Dental / Q000379:methods*; D000771:Anesthesia, Intravenous / Q000379:methods; D016292:Procedural Sedation / Q000379:methods*; D019230:Dental Audit; D004739:England; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008874:Midazolam / Q000008:administration & dosage*; D019647:Oral Surgical Procedures / Q000145:classification; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D014081:Tooth Extraction / Q000706:statistics & numerical data
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam