Clinical Study on Midazolam Intravenous Conscious Sedation for Dental Implant Surgery in a Dental Office

Abstract

Thirty patients who required Midazolam intravenous conscious sedation for dental implant surgery in a dental office, were statistically examined. The results were as follows:
1. The mean age was 58±10 years (range, 36～70 years). The mean duration of surgery was 62±48 minutes (range, 7～175 minutes). The mean dosage of Midazolam required for induction of sedation was 0.059±0.017 mg/kg (range, 0.027～0.088 mg/kg). The mean Midazolam administration rate for maintenance of adequate sedation was 3.8±1.4mg/hr (range, 1.8～6.5 mg/hr). The mean recovery time was 29±10 minutes (range, 10～50 minutes).
2. The preoperative medical questionnaire was important to understand patients' physical status, and to decide the surgical plan. However, 2 patients did not report their preoperative complications. As such, physical examination was very important just before surgery.
3. ST segment depression was observed on ECG in 10 patients, systolic blood pressure increased over 160 mmHg in 15 patients, and diastolic blood pressure increased over 100 mmHg in 7 patients, just before surgery.
4. Hypertension before surgery was decreased to the normal blood pressure level by Midazolam administration intravenously. However, blood pressure increased again during surgery (SBP＞160 mmHg, DBP＞100 mmHg) in the patients who had hypertension before surgery.
5. The dose of Midazolam and the sedation level did not affect SpO₂ depression (＜95%) by Midazolam administration intravenously.
6. The postoperative survey revealed that 57% of the patients had complete amnesia about operative events, and 97% were satisfied with this sedation and would desire similar sedation for a future procedure.
7. No serious complications occurred. Safe surgery requires that the surgeon have understanding of sedation techniques and conscious sedation (monitored anesthesia care) performed by a dental anesthetist.
8. Preoperative evaluation of the general condition, considering introduction to a central hospital, was very important in intravenous sedation in the dental office.