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Sedation with midazolam leads to reduced pain after dental surgery

Lookup NU author(s): Emeritus Professor Robin Seymour

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Abstract

Our principal objective in this study was to evaluate the potential pain reducing effect of IV midazolam in patients undergoing oral surgery. One-hundred-twenty-five patients with impacted mandibular third molars requiring removal under local anesthetic were randomized into 2 groups. The first group (n = 64) was administered IV midazolam by titration until a clinical endpoint of conscious sedation followed by local anesthetic before surgery; the second group (n = 61) was the control and was administered only local anesthetic before surgery. The surgery was performed in a standardized manner in both groups by the same surgeon. Outcome measures were four primary end-points: pain intensity as assessed by a 100-mm. visual analogue scale and a 4-point categorized scale hourly for 8 h, time to first analgesic, total analgesic (ibuprofen) consumption over the first 48 h, and a 5-point categorical patient global assessment scale (0 = poor, 1 = fair, 2 = good, 3 = very good, and 4 = excellent). Throughout the 8-h investigation period, patients in the midazolam group reported significantly lower pain intensity scores than those in the control group (19.0 +/- 13.2 mm versus 28.1 +/- 12.8 mm, P < 0.05). The patients in the midazolam group also reported significantly longer time to first analgesic (165.5 +/- 56.5 min versus 202.2 +/- 79.0 min, P < 0.05), less analgesic consumption (1275 364 mg versus 1688 +/- 407 mg, P < 0.001) and better patient global assessment (3.34 +/- 0.8 versus 2.4 +/- 0.9, P < 0.001). We conclude that systemically administered midazolam is effective in reducing postoperative pain after third molar surgery.

Publication metadata

Author(s): Ong CKS, Seymour RA, Tan JMH

Publication type: Article

Publication status: Published

Journal: Anesthesia and Analgesia

Year: 2004

Volume: 98

Issue: 5

Pages: 1289-1293

ISSN (print): 0003-2999

ISSN (electronic): 1526-7598

Publisher: Lippincott Williams & Wilkins

URL: http://dx.doi.org/10.1213/01.ANE.0000111107.18755.CC

DOI: 10.1213/01.ANE.0000111107.18755.CC

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