INTRAVENOUS SEDATION FOR HANDICAPPED DENTAL PATIENTS - A CLINICAL-TRIAL OF MIDAZOLAM AND PROPOFOL

A double blind, cross-over study to compare intravenous sedation using continuous infusions of midazolam and propofol was carried out in 18 handicapped patients, aged between 5 and 26 years. Using a syringe pump (Ohmeda 9000) midazolam was delivered at 0.4 mg/kg/h with a bolus dose of 0.02 mg/kg and propofol was infused at 4.0 mg/kg/h with a bolus dose of 0.2 mg/kg. Sequential analysis showed that induction and recovery times were shorter with propofol (P < 0.05 and P < 0.01 respectively) and more work was performed over unit time (P < 0.05), with 15.7 units of work being completed per hour on patients under propofol sedation compared to 11.0 units under midazolam. The quality of sedation was assessed as better in patients receiving propofol; eight cases were abandoned under midazolam infusion due to failure of induction, uncontrolled movement and/or emotional outbursts compared with none under propofol. All parents/patients preferred propofol sedation, because recovery was faster and smoother.