Wide variation in patient response to midazolam sedation for outpatient oral surgery

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Abstract

Intravenous midazolam in doses of between 0.07 mg/kg and 0.1 mg/kg has been recommended for sedation in dentistry and some medical procedures and investigations. This study examined the variable sensitivity of patients to midazolam. One hundred and thirty-four fit but anxious patients between the ages of 16 and 63 years received midazolam intravenously for sedation for minor oral surgery. Doses required ranged from 0.04 to 0.40 mg/kg. Nineteen patients required doses less than 0.07 mg/kg; 59 patients required doses greater than 0.1 mg/kg. The mean dose per kilogram required for males was significantly less than for females. The wide variation in sensitivity to midazolam is confirmed.

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    Citation Excerpt :

    Midazolam is a benzodiazepine with anxiolytic and sedative effects, and ketamine is a dissociative anaesthetic agent. Although both agents have been shown to be effective when used as single agents for sedation and analgesia, there is significant variation in individual response to midazolam,17 and the use of high-dose midazolam alone is more likely to be associated with respiratory depression. Ketamine as a single agent has also been associated with dysphoric reactions, which can be reduced when used in combination with midazolam.

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