Assessing the Effect of Intranasal Sedation with Midazolam on Reducing Anxiety in Patients Undergoing Mandibular Third Molars Surgery

Aims: To evaluate the efficacy of intranasal sedation with Midazolam on reducing anxiety in patients undergoing surgical removal of impacted mandibular third molars. Materials and methods: Thirty healthy individuals were included in this study of both genders; their age ranged between (18-40) years, whom were looking for surgical removal of impacted mandibular third molars under local anesthesia and they possessed moderate to severe grades of anxiety. Patients were randomly distributed into two groups: Midazolam group included fifteen patients premedicated with intranasal Midazolam using a nasal spray in concentration of 0.2 mg/kg body weight ten minutes before surgery, Placebo group included fifteen patients received oral Placebo of glucose powder capsule one hour before surgery. The following parameters were assessed: systolic blood pressure, diastolic blood pressure and anxiety score. Results: Regarding systolic blood pressure measurements: there was a statistically significant difference between Midazolam and Placebo groups after drug administration, there was a highly significant difference between Midazolam and Placebo groups during the surgical procedure as well as at the end of the surgical procedure. Regarding diastolic blood pressure measurements: there was a highly statistically significant difference between Midazolam and Placebo groups after drug administration, during the surgical procedure and at the end of the surgical procedure. Regarding anxiety: there was a highly significant difference between Midazolam and Placebo groups post-operatively. Conclusions: Intranasal administration of Midazolam is recommended as a safe, reliable and effective conscious sedation for anxious patients during surgical removal of impacted mandibular third molars.