Fentanyl Midazolam combination for endoscopy sedation is safe and effective

Kelly, Andrew; Higgins, Peter; Cunningham, Anthony J.; Hollingsworth, Jefferson F.

doi:10.1016/s0016-5085(98)80088-7

Cited by 2 publications

(2 citation statements)

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“…While maintaining patient responsiveness to verbal and tactile stimuli [ 1 ], safety of conducting moderate sedation in dental clinic is well documented with infrequent complications [ 1 2 ]. Preferred drug choices for administering moderate intravenous (IV) sedation are midazolam (benzodiazepine sedative) and fentanyl (opioid analgesic) because their safety and efficacy have been well established [ 3 4 5 6 7 8 ]. Other drug options for moderate IV sedation exist, but are beyond the scope of this article.…”

Section: Introductionmentioning

confidence: 99%

Administration order of midazolam/fentanyl for moderate dental sedation

Lobb

Clarke

Lai

2018

J Dent Anesth Pain Med

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BackgroundThe purpose of this study is to investigate the effects of administration order when a sedative drug (midazolam) and an opioid analgesic drug (fentanyl) is applied for moderate intravenous (IV) sedation in dentistry.MethodsA retrospective chart review was conducted in one dental clinic during its transition from a midazolam-first to a fentanyl-first protocol for dental procedures requiring moderate IV sedation. Physiological parameters, drug administration times, patient recovery times, drug dosages, and patient recall and satisfaction were investigated for differences.ResultsA total of 76 charts (40 midazolam-first and 36 fentanyl-first administrations), were used in the analysis. Administering midazolam first resulted in an average 4.38 min (52%) decrease in administration times (P < 0.001), and a decrease in procedural recollection immediately following the procedure (P = 0.03), and 24 to 48 hours later (P = 0.009). Administering fentanyl first required an average of 2.43 mg (29%) less midazolam (P < 0.001). No significant differences were found for change in vital signs, minimum oxygen saturation levels, recovery times, and patient satisfaction (P > 0.05). Oxygen saturation levels did not drop below 90% for either group; however, 5 cases in the fentanyl-first group fell to between 90% and 92%, compared with 0 cases in the midazolam-first group.ConclusionsThe administration order of fentanyl and midazolam may have different effects on patients and the sedation procedure. Findings from this study should be used to facilitate discussion among dental practitioners and to guide additional research investigating this topic.

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Section: Introductionmentioning

confidence: 99%

Administration order of midazolam/fentanyl for moderate dental sedation

Lobb

Clarke

Lai

2018

J Dent Anesth Pain Med

View full text Add to dashboard Cite

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“…[3][4][5][6][7][8][9][10][11][12][13][14][15] The choice of the order in which these medications are administered is left primarily up to the practitioners' preference; the effect of the order in which these medications are administered on patient outcomes has not been scientifically studied. Although every patient encounter should be individualized and there is not one universal technique that will be suitable for all patients, the authors approached this issue with a fixed-dose study protocol to determine whether the difference in the order of administration of these medications in healthy patients for routine OMS procedures would produce clinically important results.…”

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confidence: 99%