Comparison of two techniques of patient-controlled sedation with midazolam

Objective: To compare patient-controlled sedation with 1-mg increments of midazolam at 1-min intervals with 0.1-mg increments of midazolam without a lock-out interval. Design: Randomized cross over study.Subjects : 32 patients aged 17–35 years having third molars removed. Results: Doses of midazolam obtained, degree of sedation and operating conditions were similar in the two groups. The demands far exceeded the increments actually received by patients obtaining 0.1-mg increments. Some were extremely sedated with both techniques. Conclusions: In this age group, there were no significant advantages or disadvantages of one technique over the other. Patients obtained the degree of sedation they required to undergo the operation by pressing the button independently of the dose or incremental interval. So-called ‘true’ patient-controlled sedation is a misnomer. The cut-off interval proved to be an extremely important safety feature.