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  • METHODS
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  • ACKNOWLEDGMENT
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Intravenous sedation with propofol is often administered to anxious patients in dental practice. Pain on injection of propofol is a common adverse effect. This study aimed to determine the age-adjusted doses of midazolam required to erase memory of vascular pain of propofol administration and assess whether the Ramsay Sedation Scale (RSS) after the pretreatment of midazolam was useful to predict amnesia of the vascular pain of propofol administration. A total of 246 patients with dental phobia requiring dental treatment under intravenous sedation were included. Patients were classified according to their age: 30s, 40s, 50s, and 60s. Three minutes after administration of a predetermined dose of midazolam, propofol was infused continuously. After completion of the dental procedure, patients were interviewed about the memory of any pain or discomfort in the injection site or forearm. The dosage of midazolam was determined using the Dixon up-down method. The first patient was administered 0.03 mg/kg, and if memory of vascular pain remained, the dosage was increased by 0.01 mg/kg for the next patient, and then if the memory was erased, the dosage was decreased by 0.01 mg/kg. The effective dosage of midazolam in 95% of each age group for erasing the memory of propofol vascular pain (ED95) was determined using logistic analysis. The accuracy of RSS to predict the amnesia of injection pain was assessed by receiver operating characteristic (ROC) analysis. The ED95 of midazolam to erase the memory of propofol vascular pain was 0.061 mg/kg in patients in their 30s, 0.049 mg/kg in patients in their 40s, 0.033 mg/kg in patients in their 50s, and 0.033 mg/kg in patients in their 60s. The area under the ROC curve was 0.31. The ED95 of midazolam required to erase the memory of propofol vascular pain demonstrated a downward trend with age. On the other hand, it was impossible to predict the amnesia of propofol vascular pain using the RSS.

Keywords: Midazolam; Propofol; ED95 ; Vascular pain
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Copyright: © 2016 by the American Dental Society of Anesthesiology
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Article Contents

Comparison of Remimazolam and Propofol for Intubated General Anesthesia for Oral and Maxillofacial Surgery

Yoshio Hayakawa DDS, PhD,
 Keiko Fujii-Abe DDS, PhD,
 Sayaka Akitomi DDS,
 Shihomi Niwa DDS,
 Michiru Abe DDS,
 Manami Otsuka DDS, PhD,
 Maho Ikeda DDS,
 Takumi Ishikawa DDS, PhD,
 Manami Yajima DDS, PhD, and
 Hiroshi Kawahara DDS, PhD

The Impact of COVID-19 on Dental Anesthesiologists: An Online Survey of Board-Certified Dental Anesthesiology Specialists of the Japanese Dental Society of Anesthesiology

Takuro Sanuki DDS, PhD,
 Hidetaka Kuroda DDS, PhD,
 Uno Imaizumi DDS, PhD,
 Shota Tsukimoto DDS, PhD,
 Norika Katagiri DDS, PhD,
 Ayako Mizutani DDS, PhD,
 Mari Ohnaka DDS,
 Shinji Kurata DDS, PhD,
 Naotaka Kishimoto DDS, PhD, and
 Kanta Kido DDS, PhD

Tracheal Bronchus Detected During General Anesthesia: A Case Report

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 Tatsuru Tsurumaki DDS, PhD,
 Hiroko Kanemaru DDS, PhD, and
 Kenji Seo DDS, PhD

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