Intravenous Sedation for Implant Surgery: Midazolam, Butorphanol, and Dexmedetomidine Versus Midazolam, Butorphanol, and Propofol

Abstract

We compared the amnesic action, recovery process, and satisfaction of patients and surgeons after the use of 2 different sedation regimens for 40 patients undergoing scheduled implant surgery. Butorphanol, midazolam, dexmedetomidine (BMD) was administered to 20 patients who were maintained with continuous infusion of dexmedetomidine after the induction with butorphanol and midazolam, and butorphanol, midazolam, propofol (BMP) was administered to 20 patients who were maintained with continuous infusion of propofol after the induction with butorphanol and midazolam. To assess the amnesic action, the memory of local anesthesia, auditory memory, and visual memory were evaluated. The Trieger Dot Test (TDT) was applied during the recovery process. A questionnaire regarding the patient's feelings of the management of sedation was taken from each patient and was also filled out by the surgeon. The comparison between groups was analyzed by the Mann-Whitney U test. No significant differences in the amnesic action and the TDT were noted. Both methods also satisfied the patients and surgeons, as determined by the questionnaire results. In conclusion, both sedation regimens are appropriate for implant surgery.

The Effect of Dexmedetomidine on Oral Mucosal Blood Flow and the Absorption of Lidocaine

“…12 Agitation and cognitive thought rarely occur in patients sedated with DEX. 4,12,13 DEX has been used as a sedative during dental or oral surgeries. However, oral surgery is accompanied by a risk of bleeding, because of an abundance of blood vessels in this region.…”

“…12 DEX can therefore be used in sedation for oral implant surgery. 13 However, oral surgery can cause significant bleeding because of an abundance of blood vessels in the region, and this can disrupt the surgical procedure. Several interesting reports [14][15][16] have been published regarding vasoconstriction in the oral cavity.…”

Intravenous sedation in dental implant surgeries: A systematic review of hemodynamic effects

“…Several previous studies have also discussed and compared the effectiveness of different intravenous sedatives, showing a broad spectrum of efficacy. [27][28][29][30] According to the results on the hemodynamic properties, Dexmedetomidine is the most effective choice, being more effective than Propofol and Midazolam. Midazolam is known to be less effective in hemodynamics.…”

Patient-controlled sedation in procedural care

“…European guidelines recommend using fast-and short-acting drugs and monotherapy, and avoiding the use of IV-achieved pain relief [3]. Sedation from midazolam and opioids were earlier the standard, but for more than a decade and for a variety of procedures, the use of propofol has been welldocumented for endoscopy [4][5][6], dental treatment [7][8][9], renal stone therapy [10][11][12] and emergency care [13][14][15][16].…”