A comparison of patient and anaesthetist controlled midazolam sedation for dental surgery.

Thirty healthy Hong Kong Chinese patients between the ages of 15 and 31 years with bilaterally impacted lower third molar teeth, scheduled for surgical removal were studied. All the patients presented twice (for the right and left sides) and received, on separate occasions, patient or anaesthetist-controlled midazolam sedation allocated using a randomised, crossover design. Both techniques provided reliable sedation with verbal contact maintained, minimal changes in respiratory and cardiovascular function, good operating conditions and a high degree of patient satisfaction. The majority of patients (67%) thought they could sedate themselves better on a subsequent visit and were confident that they could do this more satisfactorily than the anaesthetist. An almost equal number preferred patient (n = 12) or anaesthetist (n = 13) controlled sedation, with the remainder having no preference. The total dose of midazolam was very similar in the two groups, 5.3 (SD 2.4) mg and 5.0 (SD 1.1) mg for patient and anaesthetist controlled sedation respectively.