J Korean Assoc Oral Maxillofac Surg.  2011 Jun;37(3):241-244. 10.5125/jkaoms.2011.37.3.241.

Sedative methods used during extraction of wisdom teeth in patients with a high level of dental anxiety

• Seto M
• Furuta H
• Sakamoto Y
• Kikuta T

• KMID: 2189786
• DOI: http://doi.org/10.5125/jkaoms.2011.37.3.241

Abstract

INTRODUCTION
Intravenous sedation is performed to ensure smooth and safe surgery. Dental anxiety is a reaction to an unknown danger. The Spielberger's state-trait anxiety inventory (STAI) can be used to simultaneously evaluate the levels of state and trait anxiety. State anxiety is defined as subjective feelings of nervousness. This study assessed the presurgical anxiety using STAI and performed intravenous sedation for patients whose level of state anxiety was > stage IV. Based on our clinical experience, it is believed that higher doses of sedatives are needed to induce the desired levels of sedation in patients with a high level of state anxiety.
OBJECTIVES
This study examined whether the sedative consumption of the patient with a high anxiety level increased.
PATIENTS AND METHODS
Patients with state anxiety scores of > or =51 were included in Group V, and those with state anxiety scores ranging from 42 to 50 were placed in Group IV. To induce sedation, intravenous access was established, and a bolus dose of 3.0 mg midazolam was administered intravenously. Sedation was maintained by administering a continuous infusion of propofol, which was aimed at achieving an Observer's Assessment of Alertness/Sedation scale of 10-12/20. In this study, midazolam was initially administered when the body movements appeared to occur or the blood pressure increased. This was followed by the administration of higher doses of propofol if low sedation was observed.
RESULTS
There were no significant differences in the patient demographics, duration of sedation, and doses of local anaesthetic agents between Groups IV and V. The midazolam dose and mean propofol dose needed to maintain comparable levels of sedation were significantly higher in Group V than in Group IV.
CONCLUSION
In female patients, whose level of preoperative state anxiety is more than Stage V of STAI, a large quantity of sedatives is needed for intravenous sedation.

Keyword

Intravenous sedation; Spielberger's state-trait anxiety inventory; Preoperative anxiety

MeSH Terms

Anxiety
Blood Pressure
Demography
Dental Anxiety
Dietary Sucrose
Female
Humans
Hypnotics and Sedatives
Midazolam
Molar, Third
Propofol
Dietary Sucrose
Hypnotics and Sedatives
Midazolam
Propofol

Figure

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  Fig. 1. Decision criteria of the Spielberger's state-trait anxiety inventory.

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  Fig. 2. Dose of sedatives administration. A: midazolam dosages, B: propofol dosages. *P＜0.05

Reference

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