Comparison between oral midazolam and inhaled nitrous oxide/oxygen mixture for sedation during ambulatory lower third molar surgery

Abstract

In dental surgery, patient anxiety is a common concern, potentially impacting pain tolerance. This study compared oral midazolam and nitrous oxide/oxygen (N2O/O2) inhalation as anxiety control methods. We conducted a split-mouth study for lower third molar extractions, assessing anxiety and satisfaction using Corah's scale, modified State-Trait Anxiety Inventory (STAI), and Visual Analogue Scale (VAS). We also monitored blood pressure, heart and respiratory rates, oxygen saturation, and electrocardiogram (ECG) changes non-invasively. Results showed no statistically significant differences in questionnaire-based parameters. However, fewer N2O/O2 group patients were "very anxious" on the modified STAI scale, favoring N2O for future surgeries. Regarding non-invasive blood pressure, midazolam group had higher levels, and N2O group exhibited elevated saturation, but these lacked clinical significance. In conclusion, both anxiolytic medications effectively induced adequate sedation. Questionnaire and multiparameter monitor data revealed minor variations between groups, indicating the suitability of either approach for dental surgery anxiety management.