PROPOFOL AND FENTANYL COMPARED WITH MIDAZOLAM AND FENTANYL DURING 3RDMOLAR SURGERY

Purpose: The purpose of this study was to measure the safety and effic acy of propofol combined with fentanyl as sedative agents during third molar outpatient surgery. Patients and Methods: A double-blind, prosp ective, randomized clinical trial involving 57 patients undergoing rem oval of third molars under intravenous sedation between November 1994 and December 1995 was performed. Patients randomly received either pro pofol and fentanyl (P + F, th = 24) or midazolam and fentanyl (M + F, M = 33). Patient demographics, Corah anxiety scores, and physiologic p arameters were determined preoperatively. All medications were titrate d to the same clinical end point for sedation. Intraoperative physiolo gic parameters, cooperation, alertness, and pain scores were assessed. Postoperative recovery and degree of amnesia also were determined. Re sults: There were no significant differences in either patient demogra phics or surgical characteristics between groups. The P + F group was significantly less cooperative than the M + F group. Pain during injec tion of propofol was a significant adverse side effect. Both groups ex perienced a small percentage of apneic episodes, but mechanical ventil ation was never required. There were no differences in recovery betwee n groups as measured by the Treiger dot test and psychomotor recovery scores. The degree of anterograde amnesia was greater for the M + F gr oup, although the difference was not statistically significant. Sedati on was rated good to excellent by the patient, surgeon, and observer, and there were no statistically significant differences between groups . Conclusion: Propofol appears to be a safe and efficacious drug for u se during outpatient oral surgical procedures.