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Improved sedation for oral surgery by combining nitrous oxide and intravenous Midazolam: a randomized, controlled trial

Lookup NU author(s): Professor Peter Thomson, Professor Richard Boys

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Abstract

The objective is to investigate whether sedation techniques for oral surgery can be improved by combining the use of inhalation of nitrous oxide/oxygen with intravenous Midazolam. Prospective, randomized controlled clinical trial: Patients requiring extractions or surgery were randomly allocated to subgroups receiving either intravenous Midazolam or nitrous oxide/oxygen or a combined technique using nitrous oxide/oxygen and intravenous Midazolam. Safety parameters, amount of sedative agents administered, recovery time and co-operation scores were recorded. Patients receiving the combined sedation technique were initially titrated with 10% nitrous oxide, increasing by increments of 10% up to a maximum of 40% nitrous oxide and 60% oxygen. Midazolam was then titrated (initially 2 mg wait 2 min with increments of 1 mg every minute until appropriately sedated) whilst still administering 40% nitrous oxide. When a combined technique of N2O/O2 and Midazolam was used there was a statistically significant reduction in the amount of Midazolam required to achieve effective sedation (P < 0.001), an overall significant reduction in recovery time (P < 0.001) and a significant improvement in co-operation (P < 0.01) and arterial oxygen saturation (P < 0.001). This combined technique was found to be safe and reliable, requiring reduced doses of Midazolam and demonstrable improvement in patient recovery and co-operation. © 2005 International Association of Oral and Maxillofacial Surgeons.

Publication metadata

Author(s): Venchard GR, Thomson PJ, Boys R

Publication type: Article

Publication status: Published

Journal: International Journal of Oral and Maxillofacial Surgery

Year: 2006

Volume: 35

Issue: 6

Pages: 522-527

ISSN (print): 0901-5027

ISSN (electronic): 1399-0020

Publisher: Churchill Livingstone

URL: http://dx.doi.org/10.1016/j.ijom.2005.11.003

DOI: 10.1016/j.ijom.2005.11.003

PubMed id: 16442264

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