Comparison in Sedative Effects between Dexmedetomidine and Midazolam in Dental Implantation: A Randomized Clinical Trial

Abstract

Dexmedetomidine refers to an α2-adrenergic receptor agonist causing potent sedative, analgesic, and minimal respiratory depression compared with alternative drugs. The present study was aimed at comparing the efficaciousness and safety of midazolam and dexmedetomidine as sedatives for dental implantation. We recruited 60 patients belonging to group I or II of the American Society of Anesthesiologists (ASA) and treated them with either midazolam or dexmedetomidine in a random manner. Patients’ duration of analgesia after surgery, surgeon and patient degrees of satisfaction, Observer’s Assessment of Alertness/Sedation Scale (OAAS) scores after drug administration, visual analogue scale (VAS) pain scores, and vital signs were recorded variables. Patients administered dexmedetomidine had significantly lower OAAS scores than those administered midazolam (p<0.05). Patients administrated dexmedetomidine had a significantly longer analgesia duration after the surgical procedure than those administered midazolam, and the difference was statistically significant (p<0.05). Dexmedetomidine had a significantly larger number of surgeons satisfied with the level of sedation/analgesia than midazolam (p<0.05). Accordingly, it is considered that dexmedetomidine can achieve better postoperative analgesia, surgeon satisfaction, and sedation than midazolam.

Usefulness of Continuous Low-Dose Fentanyl in Combination with Dexmedetomidine and Midazolam for Intravenous Sedation: A Randomised Controlled Trial

“…Wang et al [ 1 ] reported that, in dental implant placement, DEX reduced the intraoperative heart rate significantly more than MZ and had a lower VAS pain score 135 minutes after the start of anaesthetic administration. Furthermore, in the DEX group of Wang et al [ 1 ], the time from the start of anaesthetic administration until the use of analgesics was approximately 4 hours.…”

“…Wang et al [ 1 ] reported that, in dental implant placement, DEX reduced the intraoperative heart rate significantly more than MZ and had a lower VAS pain score 135 minutes after the start of anaesthetic administration. Furthermore, in the DEX group of Wang et al [ 1 ], the time from the start of anaesthetic administration until the use of analgesics was approximately 4 hours. In the current study, flurbiprofen axetil or acetaminophen was used at the end of surgery, and the time from the start of anaesthetic administration to the use of analgesics (as in Wang et al [ 1 ]) was approximately 6 hours in both the DM and DMF groups.…”

“…Furthermore, in the DEX group of Wang et al [ 1 ], the time from the start of anaesthetic administration until the use of analgesics was approximately 4 hours. In the current study, flurbiprofen axetil or acetaminophen was used at the end of surgery, and the time from the start of anaesthetic administration to the use of analgesics (as in Wang et al [ 1 ]) was approximately 6 hours in both the DM and DMF groups. Therefore, although intraoperative low-dose fentanyl did not have a postoperative analgesic effect, the intraoperative use of nonsteroidal anti-inflammatory analgesics may have prolonged the postoperative analgesic effect of DEX.…”

“…Dexmedetomidine (DEX) has recently become a popular intravenous sedative in dental surgery under local anaesthesia [ 1 ]. It is an agonist of α -2A-adrenergic receptors in the locus ceruleus with sedative effects mirroring that of physiologic sleep.…”

Thoracic Paravertebral Nerve Block with Ropivacaine and Adjuvant Dexmedetomidine Produced Longer Analgesia in Patients Undergoing Video-Assisted Thoracoscopic Lobectomy: A Randomized Trial

“…e addition of magnesium, clonidine, ketamine, dexamethasone, opioids, and other analgesics and local anesthetics can enhance and prolong the analgesic effect provided by PVB [8,9]. Dexmedetomidine (DEX) is a novel alpha-2 adrenergic receptor agonist with dose-dependent sedative, anxiolytic, and analgesic effects and has an advantage of minimum respiratory depression compared with alternative drugs [10]. It is well known that α-2 receptor agonists, due to their own sympathetic properties, provide stable hemodynamics during surgery and reduce the amount of narcotic analgesics.…”