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A Journal on Dentistry and Maxillofacial Surgery
Minerva Stomatologica 2006 March;55(3):99-113
language: English, Italian
Neurosedation in dentistry of the disabled patient: the use of Midazolam, Propofol, and Remifentanil
Collini S. 1, Pinto G. 1, Lejeune L. 1, Di Carlo S. 1, Meloncelli S. 1, Barraco G. 2, Gatto R. 3
1 Department of Anesthesia and Resuscitation 2nd Faculty of Medicine and Surgery La Sapienza University, Rome, Italy
2 Dentistry and Stomatology Unit University of Perugia, Perugia, Italy
3 Pedodontics Unit University of L’Aquila, L’Aquila, Italy
Aim. This prospective randomized study, deals with neurosedation in dental treatment of 200 disabled patients and unable to cooperate, subdivided in 4 groups of 50 male only patients, with age ranging from 28 to 59 (39±11), ASA I-III.
Methods. The pharmaceuticals used were Midazolam (group MID) Propofol (group Prop) and Remifentanil. Midazolam and Propofol were used following a bolus-infusion sequence, both separately and in combination among themselves (MID
PROP group), or with an opioid, Remifentanil (MID
ECG, heart rate , non invasive blood pressure (NIBP), SaO2, EtCO2 during the procedure were monitored. Induction time, duration of the sedation, recovery time and discharge were reported.
Results. The statistical analysis demonstrated the superiority of the PROP group for induction time in minute (3.1±0.5) in comparison with the MID group (10.6±2.1), the MID
PROP group (4.3±1.3) and MID
REMI (3.7±1.2). The recovery and discharge times have confirmed the superiority of the MID
REMI group in comparison with the other 3 groups.
Conclusion. This combination proved best at leveraging the synergistic characteristics of each single pharmaceutical and minimizing the collateral effects of each individually.