Factors Influencing Midazolam Dose for Intravenous Sedation in Dental Patients With Anxiety: A Retrospective Observational Study

Purpose: This study aimed to assess factors that impact midazolam dose for intravenous sedation (IVS) in dental patients with anxiety.
Materials and Methods: This was a retrospective, observational study for adult, anxious patients (moderate to severe dental anxiety) who had different types of dental procedures under IVS with midazolam and local anaesthesia. A logbook of dental patients who had dental procedures was used to collect data on an Excel sheet (Microsoft Excel Workbook 2024).
Results: Data of 233 patients were recorded. The average dose of IVS with midazolam delivered was 6.62 mg (SD = 3.24). Multivariable logistic regression found that two variables were statistically significant predictors for the IVS with midazolam dose, which are age (B = 1.30, S.E = 0.47, Exp(B) = 3.68, 95% CI = 1.45-9.33, P = 0.006) and non-surgical periodontal therapy with root planing (B = 0.85, SE = 0.39, Exp(B) = 2.35, 95% CI = 1.08–5.12, P = 0.031).
Conclusions: Younger patients and non-surgical periodontal therapy with root planing appear to be predictors for higher doses of IVS with midazolam. Other variables that were not predictors to affect IVS with midazolam dose, such as medical history, American Society of Anesthesiologists (ASA) classification, medications, and others, are crucial, and they should not be neglected when designing the treatment plan to deliver dental treatment under IVS with midazolam. Keywords: conscious sedation, dental anxiety, dental extraction, dentistry, midazolam