Dexmedetomidine and Midazolam Sedation Reduces Unexpected Patient Movement During Dental Surgery Compared With Propofol and Midazolam Sedation

Dexmedetomidine Provides Fewer Respiratory Events Compared With Propofol and Fentanyl During Third Molar Surgery: A Randomized Clinical Trial

“…Hemodynamic stability was maintained within group D, with similar findings to previous studies. 3,9,12,[14][15][16]20,29 Heart rate decreased significantly compared with propofol during the initial 10minute loading dose and steadily increased once the procedure was initiated. Patients in group P had a decrease in MAP and respiratory rate compared with group D; however, this was not statistically significant.…”

“…Dexmedetomidine has been shown to exhibit potent akinesia, which can considerably improve operating conditions. 27 In a clinical trial comparing IVS with propofol and dexmedetomidine, Togawa et al 3 found that unacceptable intraoperative patient movement occurred more commonly in the propofol group than in the dexmedetomidine group. Although unrecorded, this was a consistent observation in our study by the surgeon after the initial injection.…”

“…Several studies have shown that the addition of midazolam to sedation with dexmedetomidine provides amnesia and improves anxiolysis, which ultimately enhances sedation quality. 3,4,19 The dexmedetomidine loading dose of 1 mg/kg for 10 minutes is recommended by the manufacturer. 28 We used a maintenance dose of 0.5 mg/kg per hour in this study after reviewing protocols from previous studies that used a similar loading dose and a range of infusion rates of 0.2 to 0.8 mg/kg per hour.…”

“…1 Respiratory depression in a patient undergoing oral surgery leads to a higher risk of respiratory events such as obstruction, coughing, aspiration, and laryngospasm that will require the operator to intervene. [2][3][4][5] Propofol and fentanyl are efficacious agents for use in IVS; however, they are not without associated side effects. Propofol has the potential to cause a quick progression from deep sedation to general anesthesia, with the undesired effect of associated cardiovascular and respiratory depression.…”

“…6,[9][10][11] Dexmedetomidine facilitates cooperative sedation as the patients are uniquely arousable and cooperative when stimulated. 3,4,12 Unlike opioids, dexmedetomidine provides powerful analgesia with minimal risk of respiratory events. 13 Dexmedetomidine is a highly selective a 2 adrenergic agonist on both a 2A and a 2B receptors causing the inhibition of norepinephrine release, which terminates the propagation of pain signals.…”