11th International Dental Congress on Modern Pain Control The Essential Role of Dental Anesthesiology in the 21st Century Safe and Comfortable Dentistry 4th?7th October, 2006.

Aims. To assess the safety, acceptability of local anesthesia combined with midazolam. Methods. 100 patients who required removal of four impacted third molars aged 18–36 years old were randomly divided into two groups. Group I (test group): 50 patients were to have the teeth removed under local anaesthetic (2% lignocaine and 1/100 000 adrenaline) and i.m midazolam 0.1 mg/kg. Group II (control group): the other 50 were to have the teeth removed under the routine local anaesthetic alone. Vital signs including blood pressure, heart rate, arterial oxygen saturation and breath frequency were recorded every 2 min. anxiety scores (assessed by visual analogue scale) and patient opinions were recorded after operation too. Results. All impacted third molars were removed successfully. No mortality and serious morbidity events occurred in all patients. There is significantly different between these two groups in MAP and HR (P < 0.05). The hemodynamics was kept steadily in test group, but fluctuated greatly in control group. There is no significantly different between these two groups in SaO 2 and breath frequency. Anxiety scores were markedly lower in test group than control group (P < 0.05). 80% of the patients in test group would accepted the same operation if it were necessary, but 12% of the patients in control group would accepted it. Discussion and conclusions. Appropriate midazolam makes patients in stage I of anaesthesia. In this stage patients are relaxed and cooperative, with a decreased awareness of their surroundings, and may exhibit a diminished response to stimulation. The effect of local anesthesia combined with midazolam was significantly better than the routine local anaesthesia alone. It makes patients safe and comfortable during removal of impacted third molars.