Dexmedetomidine and midazolam equally effective sedative agents for third molar surgery

Sixty young adult patients, aged 18 to 50 years, without comorbidities, participated in the study. These individuals underwent third molar surgery, and their responses to sedation were observed and compared using the Observer’s Assessment of Alertness/Sedation scale. Patients were randomly assigned to receive either midazolam or dexmedetomidine. The effects of these sedatives on intraoperative vitals and sedation levels were assessed at 15-minute intervals.

The key findings of the study were:

• Sedation Depth: Both midazolam and dexmedetomidine were equally effective in achieving the desired level of sedation during third molar surgery. No significant differences were observed in the depth of sedation between the two groups.

• Heart Rate: Dexmedetomidine demonstrated a more efficient reduction in pulse rate compared to midazolam during the surgical procedure. However, this difference was not statistically significant.

• Blood Pressure: Dexmedetomidine exhibited a statistically significant decrease in mean diastolic blood pressure in comparison to midazolam. This suggests a potential advantage in maintaining lower blood pressure levels during the procedure.

• Arousal: Patients administered with dexmedetomidine showed quicker arousal post-surgery, indicating a favorable recovery profile compared to midazolam.

Dexmedetomidine displayed advantages in reducing diastolic blood pressure and promoting quicker arousal post-procedure. Its cardio-protective nature, anti-sialagogue properties, and potential analgesic effects highlight its potential for enhancing the management of minor oral surgical procedures like third molar surgery. The use of dexmedetomidine, with its unique properties, could offer additional benefits in minor oral surgeries, potentially improving patient outcomes and post-operative recovery.

Reference:

Jason, A. S., Sundaram, G. A., Preethi, Kumar, S. P., & Krishnan, M. Comparison of the efficacy of midazolam and dexmedetomidine as sedative agents in third molar surgery. Cureus,2023;15(11):e49477. https://doi.org/10.7759/cureus.49477