A partially blinded randomised controlled trial of patient‐maintained propofol sedation and operator controlled midazolam sedation in third molar extractions

• Published in: Anaesthesia Vol. 59; no. 9; pp. 853 - 860
• Main Authors: Leitch, J. A., Anderson, K., Gambhir, S., Millar, K., Robb, N. D., McHugh, S., Kenny, G. N. C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-09-2004; Blackwell
• Subjects: Adolescent; Adult; Anaesthesia; Anaesthetics; Anesthesia; Anesthesia, Dental - methods; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Pressure - drug effects; Conscious Sedation - methods; dental; Female; Heart Rate - drug effects; Humans; Hypnotics and Sedatives - administration & dosage; Male; Medical sciences; Mental Recall - drug effects; Midazolam; Middle Aged; Molar, Third - surgery; Oxygen - blood; Partial Pressure; Patient Compliance; Patient Satisfaction; propofol; Propofol - administration & dosage; Psychomotor Performance; Self Administration; Single-Blind Method; Tooth Extraction; Human; Anaesthetics; propofol. Anaesthesia; dental; Anesthesia; Midazolam; Propofol; Sedation
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/j.1365-2044.2004.03761.x

Summary
Patient‐maintained sedation using propofol has recently been shown to be effective for dental surgery. We compared this new technique to the established technique of operator administered midazolam. The two groups were compared before, during and after sedation. The two primary outcomes were time until discharge and oxygen saturation. Vital signs, anxiety and psychomotor skills were also compared. State anxiety was reduced to a greater extent in the propofol group (mean difference 10 (SD 4) mm; p = 0.010. Propofol patients recovered quicker (mean difference 7 (SD 1.4) min; p = 0.001). Propofol patients had a smaller reduction in arterial oxygen saturation (mean difference 0.8 (SD 0.3)%; p = 0.030), and a reduced increase in heart rate (mean difference 9 (SD 2) beats.min–1; p < 0.001). Both techniques were well tolerated and safe. Propofol sedation offered superior anxiolysis, quicker recovery, less amnesia and less depression of simple psychomotor function.