Purpose: This study aimed to analyze changes in anxiety and comfort levels at each perioperative stage during third molar extraction under single-agent intravenous midazolam sedation, and to clarify how these conditions at each perioperative stage affect postoperative satisfaction.
Patients and method: 115 who requested extraction of 1 ~ 4 third molars under single-agent intravenous midazolam sedation were targeted. These patients were administered a questionnaire survey one week after surgery. The questionnaire's five items (Anxiety before surgery, Comfort during surgery, Comfort after surgery, Amnesia, and Satisfaction) were evaluated using a visual analog scale (VAS). We investigated the correlation between each of the eight parameters which added age, operation time, and total amount of midazolam, to the VAS score. Furthermore, we compared each eight parameters according to the number of extracted wisdom teeth and sex differences.
Results: Regarding the correlation among each parameter, low preoperative anxiety were weak and positively correlated with reduced operation time reduced midazolam dosage, and an increase in postoperative comfort. All parameters influenced the patient's satisfaction level. Those levels were significantly affected by preoperative reassurance (r = 0.4402, p < 0.01), postoperative comfort (r = 0.5522, p < 0.01) amnesia (r = 0.5741, p < 0.01), and intraoperative comfort (r = 0.7578, p < 0.01). Each parameter had no significant difference depending on the number of teeth extracted. In comparison between men and women, only preoperative reassurance was significantly lower in women than in men (p<0.05).
Conclusion and relevance: This sedation effectively managed preoperative anxiety and improved postoperative satisfaction. To obtain good sedative condition, Preoperative anxiolytics are recommended. This sedation is considered particularly effective in women.
Keywords: Change of comfort status; Intravenous sedation; Midazolam; Third molar extraction; Visual analog scale.
© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.