• Pairoje Sriaroon B.Sc., D.D.S., Thai Board of Oral and Maxillofacial Surgery
• Ratachai Samol
• Watcharobon Sitisara
• Suntharee Chaisen

Objective To disclose the effects of midazolam in sedation, anxiolysis, and analgesia in healthy
patients undergoing surgical removal of impacted mandibular third molars.

Materials and methods Each of 40 healthy patients having left and right impacted mandibular third
molars underwent surgical removal in separate visits. A randomized double-blind placebo controlled
method was used for prescription of a 7.5 milligram of midazolam tablet. After oral administration of
the drug and local anaesthesia, the impacted teeth were removed surgically in a standard fashion. By
means of an observation and visual analogue scale, the clinical effects of midazolam on sedation,
anxiolysis and analgesia were investigated. The obtained data on the sedative effect were analyzed
using a Chi-square test, and those of the rest using Wilcoxon Rank Sum test.

Results Despite their insignificances, some differences in the patientsû sedative levels after taking
midazolam were detectable and higher than the control groups. Mean values of their anxiety levels
were also significantly less at the periods of 1- and 5-hour post-surgery. After local anaesthesia and
1-hour post-surgery, significantly lower levels of their pain perception were observed.

Conclusion For the patients undergoing surgical removal of impacted mandibular third molars, midazolam
orally administered is clinically useful in sedation and lowering the anxiety level. In addition, midazolam
should be orally administered 1-2 hours prior to surgery. When associated with a local anaesthetic
agent, it provides a satisfactory outcome during operation. An observation on the patientsû appearances
might be clinically insufficient and a measurement of vital signs is needed when the drug is prescribed.

(CU Dent J. 2005;28:99-108)