Comparison of vital sign stability and cost effectiveness between midazolam and dexmedetomidine during third molar extraction under intravenous sedation
김준엽, 박수윤, 한윤식, 이호,
소속 상세정보
김준엽 ( Kim Jun-Yeop ) - SMG-SNU Boramae Medical Center Department of Surgery
박수윤 ( Park Su-Yun ) - SMG-SNU Boramae Medical Center Department of Surgery
한윤식 ( Han Yoon-Sic ) - SMG-SNU Boramae Medical Center Section of Dentistry Department of Oral and Maxillofacial Surgery
이호 ( Lee Ho ) - SMG-SNU Boramae Medical Center Department of Oral and Maxillofacial Surgery
Abstract
Objectives: To compare the vital sign stability and cost of two commonly used sedatives, midazolam (MDZ) and dexmedetomidine (DEX). Patients and
Methods: This retrospective study targeted patients who underwent mandibular third molar extractions under intravenous sedation using MDZ or DEX. The predictor variable was the type of sedative used. The primary outcome variables were vital signs (heart rate and blood pressure), vital sign outliers, and cost of the sedatives. A vital sign outlier was defined as a 30% or more change in vital signs during sedation; the fewer changes, the higher the vital sign stability. The secondary outcome variables included the observer’s assessment of alertness/sedation scale, level of amnesia, patient satisfaction, and bispectral index score. Covariates were sex, age, body mass index, sleeping time, dental anxiety score, and Pederson scale. Descriptive statistics were computed including propensity score matching (PSM). The P-value was set at 0.05.
Results: The study enrolled 185 patients, 103 in the MDZ group and 82 in the DEX group. Based on the data after PSM, the two samples had similar baseline covariates. The sedative effect of both agents was satisfactory. Heart rate outliers were more common with MDZ than with DEX (49.3% vs 22.7%, P=0.001). Heart rate was higher with MDZ (P=0.000). The cost was higher for DEX than for MDZ (29.27±0.00 USD vs 0.37±0.04 USD, P=0.000).
Conclusion: DEX showed more vital sign stability, while MDZ was more economical. These results could be used as a reference to guide clinicians during sedative selection.
키워드
Conscious sedation; Third molar; Tooth extraction; Midazolam; Dexmedetomidine
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