Sedation in oral and maxillofacial day care surgery: A comparative study between intravenous dexmedetomidine and midazolam

Abstract

Introduction:Sedation is an important component of day care oral and maxillofacial surgical procedures under local anesthesia. Although various sedative drugs in different regimens have been used for sedation, an ideal agent and regimen are yet to be established.Aim:The aim of this study is to compare the efficacy of intravenous (IV) dexmedetomidine and midazolam as a sedative agent for day care oral and maxillofacial surgical procedures.Settings:The study was conducted in the Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha, India.Materials and Methods:A total of sixty adult patients of age group 18–65 years, of either sex were randomly selected equally in two groups for the study. One group named Group D received dexmedetomidine and the other named Group M received midazolam. Patients were evaluated for oxygen saturation (SPO2), respiration rate (RR), systolic blood pressure (SBP), diastolic blood pressure (DBP), Ramsay sedation score, bispectral index (BIS) score, amnesia, Aldrete score, relaxation during the surgery, and drug preference.Results:Midazolam was associated with greater amnesia. Dexmedetomidine was associated with lower heart rate, SBP, and DBP. There was no significant difference in SPO2, RR, Aldrete score, Ramsay sedation score, and BIS score between the two drugs. Patient preference and relaxation were more in dexmedetomidine group.Conclusion:IV dexmedetomidine is a comparable alternative to midazolam for sedation in day care oral and maxillofacial surgery under local anesthesia. It is the preferred drug when a lower heart rate and blood pressure or less amnesia is needed without any serious side effects.

Comparison between Dexmedetomidine and Midazolam for Sedation in Patients with Intubation after Oral and Maxillofacial Surgery

“…The America adult ICU guideline (2013 version) proposes that the primary factor for patients' agitation is pain and discomfort, which is treated by opioids as the most basic treatment [8]. Recent researches indicate that providing "analgesic priority" treatment program can effectively improve the patient's comfort for the ICU patients [9][10][11][12]. Compared with the traditional sedative treatment, this treatment is beneficial for reducing the patient's stay in the ICU [13].…”

Implant Treatment for the Patients with Severe Deep Bite Using Screwed Denture: Technical Note

“…These procedures are often associated with fear of pain, preoperative anxiety, and treatment-related mental stress. Anxiety caused by surgical procedures varies from a suppressed fear of pain to dental phobia which may make treatment impossible [10][11][12][13]. Midazolam has excellent anxiolytic qualities and is a well-established premedication agent.…”

“…It has depressant effects on the central nervous system with rapid effect and few adverse events [10,11,13]. Consequently, intravenous sedation with midazolam is advantage that the patients falls asleep and are completely unaware of the procedure being performed [11,12]. In addition, bite taking performed under an intravenous sedation is easier than that performed under general anesthesia.…”

Обзор Современных Клинических Рекомендаций По Амбулаторной Седации

“…До переваг амбулаторної анестезіології відносять еконо-мічну доцільність, зручність для хворого, ранню активізацію пацієнтів, зниження ризику тромботичних ускладнень та госпітальної інфекції, підвищення ефективності роботи лікарняних ліжок [6,7]. Сучасна анестезіологія має багатий арсенал методик та ліків для проведення анестезіологічного забезпечення амбулаторних операцій, але питання пошуку оптимальної схеми для седації, оцінки її адекватності та засобів моніторингу стану пацієнта залишаються актуальними та потребують поглибленого вивчення [8][9][10].…”