Evaluation of anterograde amnesia after the use of midazolam and valerian-hops in anxious individuals undergoing mandibular third molar extraction in a slipt-mouth, triple-blind, randomized clinical trial
DOI:
https://doi.org/10.33448/rsd-v11i11.33668Keywords:
Anxiety; Phytotherapy; Surgery, oral.Abstract
This prospective, split-mouth, triple-blind, randomized clinical trial aimed to assess whether there was anterograde amnesia when performing minimal conscious sedation with fixed extract of valerian-hops and midazolam in anxious individuals who underwent tooth extractions impacted lower third molars. The study was completed by 23 individuals aged between 18 and 25 years, of both sexes, with ASA I surgical risk classification and with impacted lower third molars positioned in a similar way bilaterally. The surgical interventions were performed by a single specialist in oral and maxillofacial surgery and traumatology, in two different sessions, with an interval of 21 days between them. Before all surgeries, each participant received an 8 mg dexamethasone capsule. Forty-five minutes before surgery, they randomly received, orally, 1 capsule of Valerian 500 mg – Hops 120 mg or midazolam 15 mg for each side to be operated on. Each participant received 12 acetaminophen 750 mg tablets to take, if needed, postoperatively. A questionnaire was used to analyze anterograde amnesia. Our results showed that midazolam presented better results in relation to anterograde amnesia. We conclude that valerian-hops is not effective in relation to anterograde amnesia, but it manages to establish comfort, few hemodynamic changes and few side effects, being an alternative to be used in the preoperative period of anxious patients who need lower third molar extraction.
References
American Dental Association. American Dental Association Guidelines for the Use of Conscious Sedation, Deep Sedation and General Anesthesia for Dentists. Chicago, IL, ADA. 1999.
American Dental Association. (2007). Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students. Chicago IL, ADA. Oct.
Aulakh, G., Shokouhi, B., Beneng, K. (2018). Retrograde amnesia after intravenous sedation and general anesthesia in a dental hospital. British Journal of Oral and Maxillofacial Surgery, 56(7): 632-35.
Cogo, K., Bergamaschi, C. C., Yatsuda, R., Volpato, M. C., Andrade, E. D. (2006). Sedação Consciente Com Benzodiazepínicos em Odontologia. Revista de Odontologia da Universidade de São Paulo, 18(2): 181-8.
Corcuera-Flores, J. R., Silvestre-Rangil, J., Cutuando-Soriano, A., López-Jiménez, J. (2016). Current methods of sedation in dental patients - a systematic review of the literature. Medicina Oral, Patologia Oral, Cirugia Bucal, 21(5): 579-86.
Dantas, L. P., De Oliveira-Ribeiro, A., De Almeida-Souza, L. M., Groppo, F. C. (2017). Effects of passiflora incarnata and midazolam for control of anxiety in patients undergoing dental extraction. Medicina Oral, Patologia Oral, Cirugia Bucal, 22(1): 95-101.
Dao, J., Zhang, J., Song, G., Xin, Q. (2014). Effect of preoperative anxiety level on postoperative pain sensation in patients receiving implant denture for partial edentulism. Journal of Southern Medical University, 34(4): 528-31.
De Moraes, M. B., Barbier, W. S., Raldi F. V., Nascimento, R. D., Dos Santos, L. M., Sato, F. R. L. (2019). Comparison of Three Anxiety Management Protocols for Extraction of Third Molars With the Use of Midazolam, Diazepam, and Nitrous Oxide: A Randomized Clinical Trial. Journal of Oral Maxilofacial Surgery, 77(11): 2258.e1-2258.e8.
Dionne, R. A. (1998). Oral sedation. Compendium of Continuing Education in Dentistry, 19(9): 868-70.
Dionne, R. A., Yagiela, J. A., Cote, C. J., Donaldson, M., Edwards, M., Greenblatt, D. J., et al. (2006). Balancing efficacy and safety in the use of oral sedation in dental outpatients. The Journal of the American Dental Association, 137(4): 502-13.
Donaldson, M., Gizzarelli, G., Chanpong, B. (2007). Oral sedation: a primer on anxiolysis for the adult patient. Anesthesia progress, 54(3): 118-28.
Farah, G. J., Ferreira, G. Z., Danieletto-Zanna, C. F., Luppi, C. R., Jacomacci, W. P. (2019). Assessment of Valeriana officinalis l. (Valerian) for Conscious Sedation of Patients During the Extraction of Impacted Mandibular Third Molars: A Randomized, Split-Mouth, Double-Blind, Crossover Study. Journal of Oral and Maxillofacial Surgery, 77(9):1796.e1-1796.e8.
Franco, L., Sánchez, C., Bravo, R., Rodriguez, A., Barriga, C., Cubero, J. C. (2012). The sedative effects of hops (Humulus lupulus), a component of beer, on the activity/rest rhythm. Acta Physiologica Hungarica, 99(2):133-39.
Germano, F., Bramanti, E., Arcuri, C., Cecchetti, F., Cicciù, M. (2013). Atomic force microscopy of bacteria from periodontal subgingival biofilm: Preliminary study results. European Journal of Dentistry, 7: 152-158.
Guldiken, I. N., Gurler, G., Delilbasi, C. (2021). Comparison of Dexmedetomidine and Midazolam in Conscious Sedation During Dental Implant Surgery: A Randomized Clinical Trial. The International Journal of Oral & Maxillofacial Implants, 36(6): e159-e165.
Kapur, A., Chawla, H. S., Gauba, K., Goyal, A., Bhardwaj, N. (2014). Effect of oral trans- mucosal midazolam sedation on anxiety levels of 3-4 years old chil- dren during a Class II restorative procedure. Contemporary Clinical Dentistry, 5: 334-9.
Köche, J.C. (2011). Fundamentos de metodologia científica: teoria da ciência e iniciação à pesquisa. Edição digital. Vozes.
Lago-Mendez, L., Freitas, M. D., Senra-Rivera, C., Seoane-Pesqueira, G., Andara-Rey, J. M., García, A. G. (2009). Postoperative recovery after removal of a lower third molar: role of trait and dental anxiety. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 108(6): 855-60.
McNeil, D. W., Helfer, A. J., Weacer, B. D., Graves, R. W., Kyle, B. N., Davis, A. M. (2011). Memory of pain and anxiety associated with tooth extraction. Journal of Dental Research, 90(2): 220-4.
Merritt, P., Hirshman, E., Hsu, J., Berrigan, M. (2005). Metamemory without the memory: are people aware of midazolam-induced amnesia? Psicofarmacologia (Berl), 177: 336-343.
Ong, C. K. S., Seymour, R. A., Chen, F. G., Ho, V. C. (2004). Preoperative ketorolac has a preemptive effect for postoperative third molar surgical pain. International Journal of Oral and Maxillofacial Surgery, 33: 771-6.
Ong, C. K. S., Lirk, P., Seymour, R. A., Jenkins, B. J. (2005). The efficacy of preemptive analgesia for acute postoperative pain management: a meta-analysis. Anesthesia & Analgesia, 100(3): 757-73.
Pinheiro, M. L. S., Alcântara, C. E. P., Moraes, M., Andrade, E. D. (2014). Valeriana officinalis L. for conscious sedation of patients submitted to impacted lower third molar surgery: A randomized, double-blind, placebo-controlled split-mouth study. Journal of Pharmacy & Bioallied Sciences, 6(2): 109-114.
Rodrigo, S. R., Cheung, L. K. (1987). Oral midazolam sedation in third molar surgery. International Journal of Oral and Maxillofacial Surgery, 6(3): 333-7.
Sanikop, S., Agrawal, P., Patil, S. (2011). Relationship between dental anxiety and pain perception during scaling. Journal of Oral Science, 53(3): 341-8.
Sivasubramani, S., Pandyan, D. A., Ravindran, C. (2019). Comparison of Vital Surgical Parameters, after Administration of Midazolam and Dexmedetomidine for Conscious Sedation in Minor Oral Surgery. Annals of Maxillofacial Surgery, 9(2): 283-288.
Seligman, L. D., Hovey, J. D., Chacon, K., Ollendick, T. H. (2017). Dental anxiety: An understudied problem in youth. Clinical Psychology Review, 55: 25–40.
Staderini, E., Patini, R., Guglielmi, F., Camodeca, A., Gallenzi, P. (2019). How to Manage Impacted Third Molars: Germectomy or Delayed Removal? A Systematic Literature Review. Medicina (Kaunas), 55: 79.
Troiano, G., Laino, L., Cicciu, M., Cervino, G., et al. (2018). Comparison of Two Routes of Administration of Dexamethasone to Reduce the Postoperative Sequelae After Third Molar Surgery: A Systematic Review and Meta-Analysis. Open Dentistry Journal, 12: 181–188.
Ustün, Y., Gündüz, M., Erdogan, O., Benlidayi, M. E. (2006). Dexmedetomidine versus midazolam in outpatient third molar surgery. Journal of Oral and Maxillofacial Surgery, 64(9):1353-8.
Wilson, T. D., McNeil, D. W., Kyle, B. N., Weaver, B. D., Graves, R.W. (2014). Effects of conscious sedation on patient recall of anxiety and pain after oral surgery. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 117(3): 277-82.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Renata Lanzoni de Oliveira ; Paulo Roberto Haidamus de Oliveira Bastos ; Janayna Gomes Paiva-Oliveira ; Ellen Cristina Gaetti Jardim ; Nathani Hevelin Moreira de Araujo ; Paulo Pereira do Nascimento; Francielly Thomas Figueiredo
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
