Watanabe Yoshihisa, Higuchi Hitoshi, Ishii-Maruhama Minako, Honda Yuka, Yabuki-Kawase Akiko, Yamane-Hirano Ayaka, Tomoyasu Yumiko, Maeda Shigeru, Miyawaki Takuya
Department of Dental Anaesthesiology, Okayama University Hospital, 2-5-1 Shikata-cho Kita-ku, Okayama, Japan.
Department of Dental Anaesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama, Japan.
Br J Oral Maxillofac Surg. 2016 May;54(4):443-8. doi: 10.1016/j.bjoms.2016.02.006. Epub 2016 Mar 19.
Some patients have transient hypertension before dental treatment as a result of anxiety and stress. Midazolam is an anxiolytic, and thought to be effective for the management of this sort of transient hypertension. We have evaluated in a randomised, controlled trial whether a low dose of midazolam can lower blood pressure in dental patients to an acceptable level without excessive sedation. Suitable patients were randomised to be given midazolam (trial group) or physiological saline (control group) intravenously. Blood pressure, heart rate, degree of anxiety, and amount of sedation were measured before and after injection. After injection, blood pressure in the trial group significantly decreased to clinically acceptable levels compared with controls. The degree of anxiety in the trial group was also significantly less than that in the control group, but there were no significant differences in sedation. These results suggest that injection of a low dose of midazolam stabilises the blood pressure of dental patients with transient hypertension.
