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Figure 6 ; Effective dosage of midazolam in 95% of each age group (ED95) required to erase the memory of injection pain calculated by logistic regression analysis. ED95 was 0.061 (95% CI, 0.047–0.304) mg/kg in patients in their 30s, 0.049 (95% CI, 0.038–0.163) mg/kg in patients in their 40s, 0.033 (95% CI, 0.028–0.067) mg/kg in patients in their 50s, and 0.033 (95% CI, 0.027–0.085) mg/kg in patients in their 60s. The left end of the graph indicates the lower end of 95% CI and the right end indicates the upper end of 95% CI. The amount of midazolam required to erase the memory of injection pain demonstrated a downward trend with age, although there were no significant differences among the 4 groups.

Aiji Boku,

Mika Inoue,

Hiroshi Hanamoto,

Aiko Oyamaguchi,

Chiho Kudo,

Mitsutaka Sugimura, and

Hitoshi Niwa

Figure 6

Effective dosage of midazolam in 95% of each age group (ED₉₅) required to erase the memory of injection pain calculated by logistic regression analysis. ED₉₅ was 0.061 (95% CI, 0.047–0.304) mg/kg in patients in their 30s, 0.049 (95% CI, 0.038–0.163) mg/kg in patients in their 40s, 0.033 (95% CI, 0.028–0.067) mg/kg in patients in their 50s, and 0.033 (95% CI, 0.027–0.085) mg/kg in patients in their 60s. The left end of the graph indicates the lower end of 95% CI and the right end indicates the upper end of 95% CI. The amount of midazolam required to erase the memory of injection pain demonstrated a downward trend with age, although there were no significant differences among the 4 groups.

Effective Dosage of Midazolam to Erase the Memory of Vascular Pain During Propofol Administration

Aiji BokuDDS, PhD,

Mika InoueDDS, PhD,

Hiroshi HanamotoDDS, PhD,

Aiko OyamaguchiDDS, PhD,

Chiho KudoDDS, PhD,

Mitsutaka SugimuraDDS, PhD, and

Hitoshi NiwaDDS, PhD

Article Category: Case Report

Volume/Issue: Volume 63: Issue 3

Online Publication Date: Jan 01, 2016

DOI: 10.2344/15-00034.1

Page Range: 147 – 155

midazolam in 95% of each group (ED 95 ). A P value of <.05 was considered to indicate statistical significance. We also conducted an assessment using an ROC curve to investigate cutoff values for the level of sedation required to erase memories of propofol vascular pain on injection. RESULTS A flow diagram of the conduct of the study is shown in Figure 1 . Of the 261 patients who were initially assessed, 246 patients were allocated to 4 groups according to their age, and 102 patients successfully completed the study without any

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Figure 1 ; The flow diagram of this study.

Aiji Boku,

Mika Inoue,

Hiroshi Hanamoto,

Aiko Oyamaguchi,

Chiho Kudo,

Mitsutaka Sugimura, and

Hitoshi Niwa

Figure 1

The flow diagram of this study.

Figure 2 ; The consecutive dose of midazolam according to the up-down method for patients in their 30s. The number of patients required to get the 15th crossover point (•→○ or ○→•) was 28. If memories of injection pain remained (•), the dosage was increased by 0.01 mg/kg for the next patient, and then if memories were erased (○), the dosage was decreased by 0.01 mg/kg.

Aiji Boku,

Mika Inoue,

Hiroshi Hanamoto,

Aiko Oyamaguchi,

Chiho Kudo,

Mitsutaka Sugimura, and

Hitoshi Niwa

Figure 2

The consecutive dose of midazolam according to the up-down method for patients in their 30s. The number of patients required to get the 15th crossover point (•→○ or ○→•) was 28. If memories of injection pain remained (•), the dosage was increased by 0.01 mg/kg for the next patient, and then if memories were erased (○), the dosage was decreased by 0.01 mg/kg.

Figure 3 ; The consecutive dose of midazolam according to the up-down method for patients in their 40s. The number of patients that was required to get the 15th crossover point (•→○ or ○→•) was 28. If memories of injection pain remained (•), the dosage was increased by 0.01 mg/kg for the next patient, and then if memories were erased (○), the dosage was decreased by 0.01 mg/kg.

Aiji Boku,

Mika Inoue,

Hiroshi Hanamoto,

Aiko Oyamaguchi,

Chiho Kudo,

Mitsutaka Sugimura, and

Hitoshi Niwa

Figure 3

The consecutive dose of midazolam according to the up-down method for patients in their 40s. The number of patients that was required to get the 15th crossover point (•→○ or ○→•) was 28. If memories of injection pain remained (•), the dosage was increased by 0.01 mg/kg for the next patient, and then if memories were erased (○), the dosage was decreased by 0.01 mg/kg.

Figure 4 ; The consecutive dose of midazolam according to the up-down method for patients in their 50s. The number of patients that was required to get the 15th crossover point (•→○ or ○→•) was 20. If memories of injection pain remained (•), the dosage was increased by 0.01 mg/kg for the next patient, and then if memories were erased (○), the dosage was decreased by 0.01 mg/kg.

Aiji Boku,

Mika Inoue,

Hiroshi Hanamoto,

Aiko Oyamaguchi,

Chiho Kudo,

Mitsutaka Sugimura, and

Hitoshi Niwa

Figure 4

The consecutive dose of midazolam according to the up-down method for patients in their 50s. The number of patients that was required to get the 15th crossover point (•→○ or ○→•) was 20. If memories of injection pain remained (•), the dosage was increased by 0.01 mg/kg for the next patient, and then if memories were erased (○), the dosage was decreased by 0.01 mg/kg.

Figure 5 ; The consecutive dose of midazolam according to the up-down method for patients in their 60s. The number of patients that was required to get the 15th crossover point (•→○ or ○→•) was 26. If memories of injection pain remained (•), the dosage was increased by 0.01 mg/kg for the next patient, and then if memories were erased (○), the dosage was decreased by 0.01 mg/kg.

Aiji Boku,

Mika Inoue,

Hiroshi Hanamoto,

Aiko Oyamaguchi,

Chiho Kudo,

Mitsutaka Sugimura, and

Hitoshi Niwa

Figure 5

The consecutive dose of midazolam according to the up-down method for patients in their 60s. The number of patients that was required to get the 15th crossover point (•→○ or ○→•) was 26. If memories of injection pain remained (•), the dosage was increased by 0.01 mg/kg for the next patient, and then if memories were erased (○), the dosage was decreased by 0.01 mg/kg.

Figure 7 ; The receiver operating characteristic (ROC) curve produced by RSS. The area under the curve (AUC) was 0.31. It is indicated by the gray zone, which shows that RSS was not a reliable predictor of amnesia.

Aiji Boku,

Mika Inoue,

Hiroshi Hanamoto,

Aiko Oyamaguchi,

Chiho Kudo,

Mitsutaka Sugimura, and

Hitoshi Niwa

Figure 7

The receiver operating characteristic (ROC) curve produced by RSS. The area under the curve (AUC) was 0.31. It is indicated by the gray zone, which shows that RSS was not a reliable predictor of amnesia.

Subject Index

Article Category: Other

Volume/Issue: Volume 63: Issue 4

Online Publication Date: Jan 01, 2016

DOI: 10.2344/0003-3006-63.4.218

Page Range: 218 – 218

Dental treatment, 185 Dentistry, 31, 139 Desflurane, 42, 91 Diagnosis of anaphylaxis, 160 ED 95 , 147 Ehlers-Danlos syndrome, 204 Electrocautery, 95 Electromagnetic interference, 95 Electrosurgery, 95 Emanuel syndrome, 201 Emergency medicine, 62 Epinephrine, 17, 71 Gag reflex, 181 General anesthesia, 31, 91, 156, 201 Health care quality improvement, 192 Hemoglobin A1c, 208 Hyperglycemia, 208 Hypermobility type, 204

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Literature Review for Office-Based Anesthesia

Mark A. SaxenDDS, PhD

Article Category: Review Article

Volume/Issue: Volume 69: Issue 4

Online Publication Date: Dec 19, 2022

DOI: 10.2344/anpr-69-04-08

Page Range: 48 – 49

more prevalent in the younger age group; however, intranasal dexmedetomidine diminished agitation as compared with the control in a dose-dependent fashion for both age groups. The ED 95 was 1.99 μg/kg (95% confidence interval 1.83–3.8) in children younger than 3 years and 1.78 μg/kg (95% confidence interval 0.93–4.29) in children at least 3 years of age. The ED 95 was also noted to decrease as the age of the child increased. Comment: The 2 major age groups in this study were chosen because children aged 3 years or younger comprised more than 20% of

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