midazolam

Using the sedative Remimazolam for oral surgery

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An interesting article titled “Can Remimazolam Be a New Sedative Option for Outpatients Undergoing Ambulatory Oral and Maxillofacial Surgery?” appears in the Journal of Oral and Maxillofacial Surgery written by Zijian Guo and et. al. (Available online 16 September 2022). The article discusses the sedative remimazolam and its possibility to sedate in oral surgery as effectively as midazolam. In the article the authors discuss how patients can receive dental treatment with more comfort using sedation. Midazolam is widely used in oral and maxillofacial surgery but has side effects of increased accumulation and respiratory depression. Remimazolam has similar pharmacological effects to midazolam but has rapid onset, fast metabolism, less potential adverse effects. Remimazolam has a a mean half-life of between 0.5 and two minutes and a terminal half-life in plasma of 37 to 53 minutes.  The authors conducted the first ever … Read more

Should Melatonin be Used for Wisdom Teeth Surgery?

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An interesting article titled “Should Melatonin Be Used as an Alternative Sedative and Anxiolytic Agent in Mandibular Third Molar Surgery?” written by Torun et al. appears in the 2019 edition of the Journal of Oral and Maxillofacial Surgery. The article seeks to compare the effects of melatonin and midazolam in patients having wisdom teeth removed. Melatonin has been discussed on this site before as a supplement that can be taken to help with sleep at night and for migraine prevention, see the post Melatonin may be more effective than Amitriptyline for Migraine Prevention. In the article by Torun the authors describe how sedatives are often given for wisdom teeth surgery but they can depress both the respiratory and cardiac systems and thus this requires increased cost for patient monitoring. When describing melatonin the authors mention how melatonin has sedative, analgesic, … Read more

Delivering Sedation in Dentistry

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It has become increasing popular to deliver sedation to patients receiving dental work. Sedation is defined as the deliberate drug-induced depression of consciousness used to reduce anxiety and awareness associated with unpleasant medical procedures. Sedation is used to reduce anxiety.  In some cases dentists or oral surgeons deliver both the dental work and the sedation, while in others there is a separate anesthesiologist to do so. One should always verify proper training and license prior to undertaking any sedation from a healthcare professional. Sedation is generally considered very safe as long as it is performed by an appropriately trained practitioner in a monitored environment. Sedation dentistry uses different approaches depending on personal choice and comfort. In the order of increasing anesthesia these are local anesthesia, minimal sedation, nitrous oxide/oxygen, moderate (conscious) sedation, deep sedation, and general anesthesia. A more thorough discussion … Read more

Does Midazolam Impact the Recovery Room Stay for Wisdom Teeth Surgery?

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An interesting article titled “Does Intravenous Midazolam Dose Influence the Duration of Recovery Room Stay Following Outpatient Third Molar Surgery?” appears in the 2015 Journal of Oral and Maxilofacial Surgery written by Kyle S. Ettinger and et al. (vol. 73, pp. 2287-2293). Midazolam is very commonly used for patients undergoing wisdom teeth surgery and the authors set out to determine if it impacts the length a patient stays in the recovery room. Intravenous (IV) midazolam has a rapid onset of effect, short duration of action, minimal impact on cardiac function, minimal effect on respiratory depression, and it produces anterograde amnesia. Some more recent literate has shown that IV midazolam might be associated with prolonged recovery time for oral surgery. Midazolam can cause postoperative cognitive impairment. The study used patients who had all four wisdom teeth removed at the Mayo Clinic in Rochester Minnesota between the ages of 14 and 29. The … Read more