Conscious Sedation in Minor Oral Surgery with Midazolam IV Versus Nasal Spray a Comparative Study

Aim: The purpose of this study was to assess the effectiveness of nasal spray midazolam by comparing it with conventional intravenous midazolam conscious sedation in minor oral surgical procedures.

Objective: To assess the safety and effectiveness of the midazolam nasal spray in comparison to its IV midazolam.

Patients and methods: Total forty number of patients were selected, and they were divided in to two groups. Group A for intra nasal midazolam atomized spray (n=20) and Group B for intravenous midazolam (n=20). Physiological parameters, anxiety score, sedation rating, patient’s cooperation score, retrograde and anterograde amnesia were recorded for each patient during preoperative, intra operative and postoperative period. Final evaluation of safety and efficacy in the nasal and intravenous routes of midazolam drug during minor oral surgery were compared.

Results: In the present study both intranasal and intravenous groups showed decrease in SBP and DBP intra operatively but in physiological limits and increase in the average pulse rates in the both groups. The average oxygen saturation levels were maintained to normal range in both the groups. The average respiratory rate decreased in the both intranasal and intravenous groups during surgical procedure. The preoperative to postoperative anxiety scores were decreased significantly in the both groups and there was no significant difference in pre to postoperative anxiety scores in between the groups.

Conclusion: Both intravenous and intranasal routes of administration of midazolam showed patient cooperation, satisfaction and clinical effectiveness. Intranasal route of midazolam spray is effective in reduction of subjective stress feelings, reliable anxiolysis while preserving protective reflexes.

Author(s): Kiran PM, Haripriya C, Khadar Vali Shaik, Venkatesh V, Pavan Kumar B and Ramesh K

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