A study to assess the value of bispectral analysis in intravenous sedation with midazolam during third molar surgery under local anaesthesia

Anaesthesia. 2008 Dec;63(12):1302-8. doi: 10.1111/j.1365-2044.2008.05652.x.

Abstract

This study aimed to determine whether bispectral index (BIS) can be used as an indicator of sedation and recovery with intravenous midazolam. In Part A, 30 healthy patients undergoing third molar extraction under local anaesthesia were recruited. They were sedated with intravenous midazolam titrated to clinical endpoints. BIS values were recorded when adequately sedated (BIS(S)) and when clinical recovery criteria were met (BIS). In Part B, another 30 patients were sedated to the range of BIS(S) obtained in Part A. Recovery was assessed postoperatively when the range of BIS(R) from Part A was reached. BIS titrated patients required less midazolam (p < 0.001). Seventy percent of Part B patients required increments of midazolam during surgery, compared to 16.7% in Part A (p < 0.001). Total dose of midazolam given was lower in Part B (p = 0.025). BIS is not effective as a sole indicator of endpoint in sedation with intravenous midazolam.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anesthesia Recovery Period
  • Anesthesia, Dental / methods
  • Anesthesia, Local
  • Conscious Sedation / methods*
  • Drug Administration Schedule
  • Electroencephalography / drug effects*
  • Female
  • Humans
  • Hypnotics and Sedatives / administration & dosage*
  • Hypnotics and Sedatives / pharmacology
  • Male
  • Mental Recall / drug effects
  • Midazolam / administration & dosage*
  • Midazolam / pharmacology
  • Molar, Third / surgery*
  • Monitoring, Intraoperative / methods
  • Tooth Extraction
  • Young Adult

Substances

  • Hypnotics and Sedatives
  • Midazolam