Comparison of bite force after administration of midazolam and dexmedetomidine for conscious sedation in minor oral surgery

Abstract

Aim: The aim of this study was to compare the bite force and sedation score in moderate/conscious sedation for minor oral surgical procedure. Materials and Methods: A sample size of 30 was selected in each group (group M [midazolam] and group D [dexmedetomidine]). Results: Dexmedetomidine group had a statistically significant sedation score than midazolam. A statistically significant increase in the bite force was observed in both midazolam and dexmedetomidine groups, but there was no significant difference between the two groups. Conclusion: Dexmedetomidine and midazolam significantly increased the bite force because of the loss of proprioceptive function of periodontal ligament, but there was no significant difference between the drugs regarding bite force.

Effects of dexmedetomidine in non-operating room anesthesia in adults: a systematic review with meta-analysis

“…Overall, the majority of the studies (62.6%) reported either a better sedation profile with DEX groups, with higher achievement of the desired level of sedation for the procedure (n = 26) 15 , 86 , 107 , 32 , 82 , 41 , 23 , 36 , 109 , 38 , 96 , 19 , 99 , 54 , 77 , 67 , 35 , 73 , 80 , 57 , 58 , 92 , 101 , 70 , 37 , 60 ; or no difference at all when compared to the control groups (n = 21). 48 , 51 , 28 , 61 , 24 , 69 , 111 , 95 , 43 , 52 , 55 , 53 , 74 , 105 , 72 , 97 , 46 , 26 , 76 , 93 , 102 Twenty four percent of studies reported DEX regimens as either insufficient for adequate sedation during the procedure or as having a higher demand for rescue medication 16 , 20 , 64 , 106 , 59 ,…”

“… Shetty 16 India (18–35) NR 15 1 Surgical removal of the third molar NIBP, pulse oximeter and modified OAA/S score 1: 1.5 LG kg −1 intranasal atomized DEX 2: Intranasal normal saline 30 min before the procedure No clear definition Sedation score and pain. Sivasubra-mani 32 (1) India (18–40) NR 30 1, 2 Minor oral surgery HR, SBP, DBP, ECG, SpO 2 and RR 1: 1 μg.kg −1 .h −1 infusion DEX for 10 min + 0.5 μg.h −1 infusion DEX 2: 0.05 mg.kg −1 infusion MDZ + 0.5 μg.h −1 infusion MDZ Before and during the procedure No clear definition Vital signs, sedation score, pain, cognitive judgment, amnesia, patient ambulatory status and surgical wound and output. Sivasubra-mani 32 (2) India (18–40) NR 60 1, 2 Minor oral surgery HR, ECG, pulse oximeter, SpO 2 , BP, RR and RSS 1: 1 μg.kg −1 .h −1 iv infusion DEX for 10 min + 0.5 μg.h −1 infusion DEX 2: 0.05 mg.kg −1 iv infusion MDZ for 10 min + infusion normal saline Before and during the procedure No clear definition RSS and bite force.…”

“… Sivasubra-mani 32 (1) India (18–40) NR 30 1, 2 Minor oral surgery HR, SBP, DBP, ECG, SpO 2 and RR 1: 1 μg.kg −1 .h −1 infusion DEX for 10 min + 0.5 μg.h −1 infusion DEX 2: 0.05 mg.kg −1 infusion MDZ + 0.5 μg.h −1 infusion MDZ Before and during the procedure No clear definition Vital signs, sedation score, pain, cognitive judgment, amnesia, patient ambulatory status and surgical wound and output. Sivasubra-mani 32 (2) India (18–40) NR 60 1, 2 Minor oral surgery HR, ECG, pulse oximeter, SpO 2 , BP, RR and RSS 1: 1 μg.kg −1 .h −1 iv infusion DEX for 10 min + 0.5 μg.h −1 infusion DEX 2: 0.05 mg.kg −1 iv infusion MDZ for 10 min + infusion normal saline Before and during the procedure No clear definition RSS and bite force. Taniyama 33 Japan NR 21.4 14 1 Minor oral surgery BP, HR, SpO 2 , Mackenzie's sedation assessment score and BIS 1: 6 mg.kg −1 .h −1 iv DEX hydrochloride for 10 min + 0.4 μg.kg −1 .h −1 infusion DEX hydrochloride 2: 20 mg iv lidocaine hydrochloride + 0.5 mg.kg −1 bolus propofol + 4 mg.kg −1 .h −1 infusion propofol Before and during the procedure No clear definition Amnesia, comfort, sedation score and hemodynamic and respiratory effects.…”

“…The studies included were from 2004 onward, 21 from before 2013 and 75 from 2013 onward. Twenty-three studies were conducted in India, 16 , 17 , 86 , 48 , 51 , 20 , 90 , 28 , 61 , 64 , 65 , 66 , 30 , 21 , 106 , 107 , 84 , 71 , 108 , 32 , 82 , 78 , 68 sixteen in China, 41 , 87 , 88 , 59 , 23 , 24 , 25 , 89 , 81 , 36 , 109 , 69 , 110 , 111 , 95 , 103 thirteen in Turkey, 38 , 96 , 98 , 40 , 43 , 44 , 19 , 99 , 52 , 55 , 56 , 104 , 22 nine in Japan, 49 , 27 , 54 , 63 , 77 , 67 , …”

“…Twenty-five trials were judged to be low risk of bias in all domains. 86 , 90 , 64 , 66 , 107 , 78 , 68 , 41 , 87 , 23 , 24 , 25 , 81 , 36 , 69 , 103 , 58 , 92 , 105 , 29 , 85 , 37 , 62 , 47 , 93 Forty trials had unclear risk of bias, 15 , 16 , 51 , 20 , 28 , 30 , 21 , 106 , 84 , 108 , 32 , 82 , 89 , 109 , 110 , 95 , 96 , 40 , 19 , 52 , 56 , 22 , 49 , 27 , 54 , 72 , 39 , 83 , 70 , 60 , 45 , 50 , 79 , 102 …”