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

Aims: The present study aimed 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 of both genders were included in this study of both genders; their ages ranged between 18-40 years, who 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 assigned to two groups: the Midazolam group included fifteen patients who were premedicated with intranasal Midazolam using a nasal spray in a concentration of 0.2 mg/kg body weight ten minutes before surgery; the Placebo group included fifteen patients who received an oral Placebo of glucose powder capsules 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 the Midazolam and Placebo groups after drug administration. There was a highly significant difference between the 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 the 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 the Midazolam and Placebo groups post-operatively. Conclusion: Intranasal administration of Midazolam is recommended as a safe, reliable, and effective conscious sedation for anxious patients during the surgical removal of impacted mandibular third molars.