MULTIDRUG INTRAVENOUS SEDATION - DETERMINANTS OF THE SEDATIVE DOSE OFMIDAZOLAM

Objectives. The efficacy of multidrug intravenous sedation regimens in oral surgery is based on the ability to titrate opioids, benzodiazepi nes, and barbiturates to a desired level of relaxation. Dosage require ments to reach the initial sedation end points of slurred speech and p tosis of eyelids vary widely from one patient to another. Study design . An assessment of physical, cardiovascular, behavioral, and pharmacol ogic factors that;might predict midazolam dosage requirements for the initial sedation titration was carried out with data collected from a large controlled clinical trial of fentanyl, midazolam, and methohexit al sedation for third molar surgery. Results. Dosage requirements for the initial titration of midazolam were found to be significantly high er when fentanyl was not included in the sedation regimen and when pre sedation heart rate and presedation systolic blood pressure were eleva ted.