Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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The clinical study on the sedative effect and recovery in patients undergoing intravenous conscious sedation with midazolam for mandibular third molars extraction

하악 제3대구치 발치 시 midazolam을 사용한 정맥진정법의 진정효과에 관한 임상적 연구

  • Kwak, Ju-Hee (Department of Oral and Maxillofacial Surgery, Mokdong Hospital, School of Medicine, Ewha Womans University) ;
  • Jang, Jin-Hyun (Department of Oral and Maxillofacial Surgery, Mokdong Hospital, School of Medicine, Ewha Womans University) ;
  • Kim, Jin-Woo (Department of Oral and Maxillofacial Surgery, Mokdong Hospital, School of Medicine, Ewha Womans University) ;
  • Kim, Myung-Rae (Department of Oral and Maxillofacial Surgery, Mokdong Hospital, School of Medicine, Ewha Womans University) ;
  • Kim, Sun-Jong (Department of Oral and Maxillofacial Surgery, Mokdong Hospital, School of Medicine, Ewha Womans University)
  • 곽주희 (이화여자대학교 의학전문대학원 목동병원 치과학교실 구강악안면외과학) ;
  • 장진현 (이화여자대학교 의학전문대학원 목동병원 치과학교실 구강악안면외과학) ;
  • 김진우 (이화여자대학교 의학전문대학원 목동병원 치과학교실 구강악안면외과학) ;
  • 김명래 (이화여자대학교 의학전문대학원 목동병원 치과학교실 구강악안면외과학) ;
  • 김선종 (이화여자대학교 의학전문대학원 목동병원 치과학교실 구강악안면외과학)
  • Received : 2010.06.20
  • Accepted : 2010.10.20
  • Published : 2010.10.29
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Abstract

Introduction: This study examined the depth of sedation and the usefulness of the monitoring tool in determining the level of sedation in patients undergoing third molars extraction under conscious sedation with midazolam. Materials and Methods: Twenty two patients undergoing third molars extraction at the department of Oral and Maxillofacial surgery, Ewha Womans Mokdong Hospital from February 2010 to April 2010 were analyzed. All patients were classified as American Society of Anesthesiologist (ASA) class I and had no contraindications tosedation. The bispectral index was recorded continually during surgery using a bispectral monitor. The initial sedation was accomplished using a 3 mg bolus of midazolam followed by a 2 mg bolus of midazolam until the level of sedation, at which the patient’s eyes were closed or the subject was responsive only to loud or repeated calling of their name, was reached. All subjects were surveyed with a postoperative questionnaire to evaluate the level of sedation. Results: The bispectral index (BIS) decreased approximately 5 minutes after midazolam administration, but increased at the local anesthesia injection and odontomy procedure. The amnestic effect was shown effectively in the early stages of surgery. Conclusion: Conscious sedation with intravenous midazolam is effective in achieving the effect of anxiolysis, analgesia and amnesia. The BIS is an objective and useful means of assessing the depth of sedation.

Keywords

References

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