A COMPARISON OF DEXMEDETOMIDINE AND MIDAZOLAM FOR INTRAVENOUS SEDATION IN OUTPATIENT LOWER THIRD MOLAR SURGERY (RANDOMIZED CONTROLLED TRIAL, SPLIT-MOUTH TECHNIQUE)

Abstract

The objective of this research was to compare the anxiolytic efficacy of Dexmedetomidine and Midazolam in patients undergoing surgical removal of impacted mandibular third molars. This study was designed as a randomized, double-blind, controlled clinical trial using a split-mouth technique. Twelve participants who qualified for inclusion in the study were randomly allocated to two groups. In Group A, patients received intravenous sedation with Dexmedetomidine (1 μg/kg) before first procedure and Midazolam (0.1 mg/kg) before the second procedure. In Group B, start with Midazolam followed by Dexmedetomidine respectively. A washout period was at least 3 weeks. Anxiety levels were assessed using Corah’s dental anxiety scale (CDAS) before sedation and postoperatively once the patient had fully recovered. A three-digit recall test was performed to assess memory. Post-operative pain at 1, 3, 6 hours and the time of first analgesic consumption were recorded. Both Dexmedetomidine and Midazolam were statistically significant reduction in anxiety levels, as evidenced by significant decreases in CDAS from preoperative to postoperative assessments (p<0.05). However, no significant intergroup difference was observed in anxiolytic efficacy. Dexmedetomidine was associated with lower pain scores at all time points and prolonged time to first rescue analgesia compared to Midazolam. A statistically significant difference in amnestic effect was observed in Midazolam group. No nausea or vomiting was observed in either group. However, the small sample size limits the statistical power and generalizability of the findings

Keywords: Dexmedetomidine, Midazolam, Third molar surgery, Anxiety, Sedation