The effectiveness of intravenous sedation with midazolam for people with Alzheimer's disease requiring dental extraction.

Aim: To assess the effectiveness of the elderly regimen of intravenous sedation (IVS) with midazolam for people with Alzheimer's disease (>65 years old) who required dental extraction. Materials and methods: This was a retrospective clinical series of people with late, middle and early stages of Alzheimer's disease who had dental extraction under IVS with midazolam. Demographic characteristics such as age, gender and past medical history of the patients were collected from the medical records. Non‐invasive blood pressure, oxygen saturation measured via pulse oximetry and heart rate before and after dental treatment were also collected for each patient. The mental capacity of each patient was assessed using the Mental Capacity Act's four steps. All patients had dental extraction under local anaesthesia and IVS with midazolam. Each patient was injected 1 mg of midazolam over 30 s; pause for 4 min and an additional 0.5 mg increment was added every 2 min until adequate sedation was reached with a minimum of 90% of oxygen saturation. The quality of sedation was assessed using Ellis Sedation Scores. Results: Midazolam dosage varied between 0.5 and 1.5 mg. All patients showed good (grade II) quality of sedation level as measured by Ellis Sedation Scores. This helped to deliver safe dental extraction. Conclusions: As the association between general anaesthesia and cognitive level in people with Alzheimer's disease is mixed and still needs further studies, this retrospective clinical series study showed that people with Alzheimer's can benefit from the elderly regimen of IVS with midazolam in providing safe and effective dental extraction when delivered properly. [ABSTRACT FROM AUTHOR]