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  • Abstract
  • MATERIALS AND METHODS
  • RESULTS
  • DISCUSSION
  • CONCLUSION
  • REFERENCES
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Abstract

Moderate intravenous (IV) sedation combined with local anesthesia is common for outpatient oral surgery procedures. An ideal sedative agent must be safe and well tolerated by patients and practitioners. This study evaluated fospropofol, a relatively new sedative/hypnotic, in comparison to midazolam, a commonly used benzodiazepine, for IV moderate sedation during oral and maxillofacial surgery. Sixty patients were randomly assigned to either the fospropofol or the midazolam group. Each participant received 1 μg/kg of fentanyl prior to administration of the selected sedative. Those in the fospropofol group received an initial dose of 6.5 mg/kg, with 1.6 mg/kg supplemental doses as needed. Those in the midazolam group received initial doses of 0.05 mg/kg, followed by 0.02 mg/kg supplemental doses. The quality of sedation in each patient was evaluated with regard to (a) onset of sedation, maintenance, and recovery profile; (b) patient and surgeon satisfaction; and (c) hemodynamic stability and adverse effects. The fospropofol group demonstrated shorter physical recovery times than midazolam patients, taking a mean of 11.6 minutes versus 18.4 minutes for physical recovery (P = .007). Cognitive recovery comparison did not find any difference with a mean of 7.5 minutes versus 8.8 minutes between the 2 drug groups (P = .123). The fospropofol group had a higher rate of local anesthetic injection recall (90.5 vs 44.4%, P = .004). Other parameters of recall were comparable. Two adverse effects demonstrated significance, with more patients in the midazolam group experiencing tachycardia (48.2 vs 9.4%, P = .001), and more patients in the fospropofol group experiencing perineal discomfort (40.6 vs 0, P < .001). No significant difference was found in any other measures of sedation safety, maintenance, or satisfaction. Fospropofol, when administered intravenously by a dentist anesthesiologist at the indicated dose in this study, appears to be a safe, well-tolerated alternative to midazolam for intravenous moderate sedation during minor oral surgery procedures.

Keywords: Fospropofol; Midazolam; Moderate sedation; Outpatient surgery; IV conscious sedation; Benzodiazepine; Propofol
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Citations

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Article Contents

Perioperative Management of a Patient With Idiopathic Pulmonary Hypertension and a History of Syncope: A Case Report

Aiji Sato (Boku) DDS, PhD;,
 MinHye So MD, PhD;,
 Kazuma Fujikake MD, PhD;,
 Motoshi Tanaka MD;,
 Yuji Kamimura MD, PhD;,
 Haruko Ota MD, PhD;,
 Tomomi Mizutani DDS,
 Kenichiro Ishibashi DDS, PhD;,
 Yasuyuki Shibuya DDS, PhD;, and
 Kazuya Sobue MD, PhD

How Safe Is Anesthesia Management by Dentist Anesthesiologists? The Need for an International Collaborative Study on the Safety of Anesthesia Management by Dentist Anesthesiologists

Takuro Sanuki DDS, PhD,
 Shota Tsukimoto DDS, PhD,
 Hidetaka Kuroda DDS, PhD,
 Uno Imaizumi DDS, PhD, and
 Naotaka Kishimoto DDS, PhD

General Anesthetic Management of a Patient With Spondyloepiphyseal Dysplasia Congenita Undergoing Palatoplasty Revision

Hiroka Hattori DDS,
 Aiji Sato (Boku) DDS, PhD,
 Mayuko Kanazawa DDS, PhD,
 Erika Harada DDS,
 Mami Asai DDS,
 Yuko Shikama DDS,
 Hiroko Kobayashi DDS,
 Makoto Hirohata DDS,
 Naoko Tachi DDS, PhD, and
 Masahiro Okuda MD, PhD
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