Efficacy of oral midazolam prior to intravenous sedation for the removal of third molars.

The combination of oral and intravenous sedation has not been well investigated and this study examined the combination's effect on amnesia, anxiety, cardiovascular stability and recovery in a double blind, cross-over, placebo controlled trial. Patients were given 7.5 mg oral midazolam or placebo 1 h prior to intravenous midazolam and surgery. This investigation demonstrated significant anxiolysis, amnesia and patient preference for oral midazolam compared to placebo. There was no significant effect on cardiovascular stability, the intravenous dose of midazolam used or post-operative recovery. Low dose oral midazolam prior to intravenous sedation may be beneficial in very anxious patients, particularly if surgery is delayed.