Comparison of intravenous sedation using midazolam during dental treatment in elderly patients with/without dementia: a prospective, controlled clinical trial
Abstract The effects of intravenous sedation with midazolam on the cerebral function of elderly patients with severe dementia are unclear. This study aimed to evaluate its effects on parameters such as brainwaves and cerebral blood flow (CBF) and compare them between elderly individuals with dementi...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2021-02-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-83122-2 |
| _version_ | 1818845356617629696 |
|---|---|
| author | Yuichi Tatsuno Yoshinari Morimoto Megumi Hayashi Takatoshi Iida |
| author_facet | Yuichi Tatsuno Yoshinari Morimoto Megumi Hayashi Takatoshi Iida |
| author_sort | Yuichi Tatsuno |
| collection | DOAJ |
| description | Abstract The effects of intravenous sedation with midazolam on the cerebral function of elderly patients with severe dementia are unclear. This study aimed to evaluate its effects on parameters such as brainwaves and cerebral blood flow (CBF) and compare them between elderly individuals with dementia and without cognitive impairment. Ten patients with severe dementia and 10 without cognitive impairment were registered. The bispectral index (BIS) and normalized tissue hemoglobin index (nTHI), which reflects CBF using near-infrared spectroscopy, were measured. Midazolam was administered until a Modified Observer’s Assessment of Alertness/Sedation score of 2 was reached. The chi-squared, Mann–Whitney U, Wilcoxon signed-rank, and Friedman tests and multiple regression analysis were used for comparisons. Whereas a similar decline in BIS values was observed in both groups after midazolam administration (P < 0.018), there was a significant decrease by 9% in the nTHI of the dementia-positive group (P < 0.013). However, there was no significant difference in the nTHI between the dementia-positive and dementia-negative group according to the multiple regression analysis (P = 0.058). In the dementia-negative group, none of the measured values differed from the baseline values. In the dementia-positive group, sedation with midazolam resulted in a 9% decrease in the CBF. |
| first_indexed | 2024-12-19T05:28:22Z |
| format | Article |
| id | doaj.art-14cd0029bf184bb3a575bee0f1375159 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-19T05:28:22Z |
| publishDate | 2021-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-14cd0029bf184bb3a575bee0f13751592022-12-21T20:34:18ZengNature PortfolioScientific Reports2045-23222021-02-0111111210.1038/s41598-021-83122-2Comparison of intravenous sedation using midazolam during dental treatment in elderly patients with/without dementia: a prospective, controlled clinical trialYuichi Tatsuno0Yoshinari Morimoto1Megumi Hayashi2Takatoshi Iida3Department of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental UniversityDepartment of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental UniversityDepartment of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental UniversityDepartment of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental UniversityAbstract The effects of intravenous sedation with midazolam on the cerebral function of elderly patients with severe dementia are unclear. This study aimed to evaluate its effects on parameters such as brainwaves and cerebral blood flow (CBF) and compare them between elderly individuals with dementia and without cognitive impairment. Ten patients with severe dementia and 10 without cognitive impairment were registered. The bispectral index (BIS) and normalized tissue hemoglobin index (nTHI), which reflects CBF using near-infrared spectroscopy, were measured. Midazolam was administered until a Modified Observer’s Assessment of Alertness/Sedation score of 2 was reached. The chi-squared, Mann–Whitney U, Wilcoxon signed-rank, and Friedman tests and multiple regression analysis were used for comparisons. Whereas a similar decline in BIS values was observed in both groups after midazolam administration (P < 0.018), there was a significant decrease by 9% in the nTHI of the dementia-positive group (P < 0.013). However, there was no significant difference in the nTHI between the dementia-positive and dementia-negative group according to the multiple regression analysis (P = 0.058). In the dementia-negative group, none of the measured values differed from the baseline values. In the dementia-positive group, sedation with midazolam resulted in a 9% decrease in the CBF.https://doi.org/10.1038/s41598-021-83122-2 |
| spellingShingle | Yuichi Tatsuno Yoshinari Morimoto Megumi Hayashi Takatoshi Iida Comparison of intravenous sedation using midazolam during dental treatment in elderly patients with/without dementia: a prospective, controlled clinical trial Scientific Reports |
| title | Comparison of intravenous sedation using midazolam during dental treatment in elderly patients with/without dementia: a prospective, controlled clinical trial |
| title_full | Comparison of intravenous sedation using midazolam during dental treatment in elderly patients with/without dementia: a prospective, controlled clinical trial |
| title_fullStr | Comparison of intravenous sedation using midazolam during dental treatment in elderly patients with/without dementia: a prospective, controlled clinical trial |
| title_full_unstemmed | Comparison of intravenous sedation using midazolam during dental treatment in elderly patients with/without dementia: a prospective, controlled clinical trial |
| title_short | Comparison of intravenous sedation using midazolam during dental treatment in elderly patients with/without dementia: a prospective, controlled clinical trial |
| title_sort | comparison of intravenous sedation using midazolam during dental treatment in elderly patients with without dementia a prospective controlled clinical trial |
| url | https://doi.org/10.1038/s41598-021-83122-2 |
| work_keys_str_mv | AT yuichitatsuno comparisonofintravenoussedationusingmidazolamduringdentaltreatmentinelderlypatientswithwithoutdementiaaprospectivecontrolledclinicaltrial AT yoshinarimorimoto comparisonofintravenoussedationusingmidazolamduringdentaltreatmentinelderlypatientswithwithoutdementiaaprospectivecontrolledclinicaltrial AT megumihayashi comparisonofintravenoussedationusingmidazolamduringdentaltreatmentinelderlypatientswithwithoutdementiaaprospectivecontrolledclinicaltrial AT takatoshiiida comparisonofintravenoussedationusingmidazolamduringdentaltreatmentinelderlypatientswithwithoutdementiaaprospectivecontrolledclinicaltrial |