Comparison of dexmedetomidine with midazolam for dental surgery

Abstract

Introduction: Dexmedetomidine and midazolam have become important approaches for the sedation of dental surgery. However, the comparison of these 2 drugs for the sedation of dental surgery has not been well established. We conduct a systematic review and meta-analysis to evaluate the efficacy of dexmedetomidine versus midazolam for dental surgery. Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials are searched. Randomized controlled trials (RCTs) assessing the influence of dexmedetomidine versus midazolam on dental surgery are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. Meta-analysis is performed using the random-effect model. Results: Five RCTs and 420 patients are included in the meta-analysis. Compared with midazolam intervention for dental surgery, dexmedetomidine intervention has similar lowest SpO 2 , lowest heart rate and lowest systolic blood pressure, duration of surgery, and total volume of local anesthetic, but is associated with stable and reduced lowest diastolic blood pressure. Conclusions: Similar benefits of dexmedetomidine and midazolam intervention are observed for the sedation of dental surgery in terms of SpO 2 , heart rate, systolic blood pressure, and the volume of local anesthetic, but dexmedetomidine may result in more stable diastolic blood pressure.

Comparison of Efficacy and Safety of Midazolam versus Nitrous Oxide as Sedative Agents during Paediatric Dental Treatment: A Systematic Review

“…Sneezing and hiccups were also seen in the intranasal groups. Midazolam-induced anterograde amnesia [27] may be advantageous during painful procedures such as extractions, and the children under midazolam sedation were more forgetful of the therapy when compared to the nitrous oxide group [18][19][20].…”

A comparative study of patient satisfaction about anesthesia with dexmedetomidine for ambulatory dental surgery

“…Reports about the use of dexmedetomidine for MAC in dental surgery in adult patients mainly compared the combination of the intravenous formula of dexmedetomidine and various short-and long-acting drugs with common hypnotics (e.g., midazolam, fentanyl, remifentanil, ketamine) [3][4][5]. Overall, the use of dexmedetomidine offered better sedation and better postoperative analgesia compared to midazolam [6,7].…”

Comparison of vital sign stability and cost effectiveness between midazolam and dexmedetomidine during third molar extraction under intravenous sedation

“…Surgical extraction of the third molar is a common procedure performed in oral and maxillofacial surgery; however, it can cause extreme stress in patients who experience fear and anxiety about dental treatment. Sedation is useful, as it can reduce the fear of tooth extraction and increase satisfaction with dental treatment 1 .…”

“…MDZ is a derivative of benzodiazepine with sedative, anti-anxiety, muscle relaxant, and anticonvulsant properties. It promotes cardiopulmonary stability, has multiple routes of administration and a short half-life, induces antecedent memory loss, and results in good patient satisfaction 1 , 4 . DEX exhibits effective sedative, analgesic, and anxiolytic effects with minimal respiratory system suppression 4 .…”