A Comparison of the Effect of Remimazolam and Midazolam on Recovery and Preserved Memory Function for Patients with Dental Extraction Anxiety

Authors

• Quan Jing
• Weijia Wang
• Limeng Wu
• Lejunzi Wang
• Boru Yuan
• Yan Wang
• Chengbin Wang
• Lin Liu
• Lei Guan
• Riyue Yu
• Yuelun Zhang
• Daniel I Sessler
• Yuguang Huang
• Kuo Wan
• Lijian Pei

Language

English

Publication Date

1-1-2025

Journal

Drug Design, Development and Therapy

DOI

10.2147/DDDT.S551322

PMID

41488759

PMCID

PMC12764204

PubMedCentral® Posted Date

12-30-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Purpose: Remimazolam is an ultrashort-acting benzodiazepine, which has been indicated to be effective in endoscopic surgery and general anaesthesia. Research on its use in outpatient dental procedures remains limited. This triple-blinded randomized clinical trial was designed to determine whether the quality of postoperative recovery is better with continuous intravenous remimazolam administration compared with midazolam administration for impacted wisdom tooth extraction in patients with dental anxiety.

Patients and methods: This study was a randomized, parallel triple-blinded, superiority trial conducted between 30 April 2022 and 24 June 2024. Participants aged ≥18 years who exhibited dental anxiety and who were eligible for impacted wisdom tooth extraction in an outpatient setting were included in this study. Participants were randomly assigned at a 1:1 ratio to receive either a continuous intravenous infusion of remimazolam or midazolam. The primary outcome was the time to recover full alertness. The secondary outcome was postoperative anterograde amnesia.

Results: A total of 150 participants were randomized in this study, with 75 patients assigned to the remimazolam group and 75 patients assigned to the midazolam group. The time to complete alertness was significantly shorter in the remimazolam group than in the midazolam group (3.0 ± 3.6 min vs 4.7 ± 5.2 min, mean difference, -1.9 min; 95% CI, -3.3min to -0.4 min; P = 0.013). The odds of immediate and delayed anterograde amnesia were much reduced with remimazolam administration compared with midazolam administration (immediate: 0.14, 95% CI, 0.05 to 0.34, delayed: 0.07, 95% CI, 0.03 to 0.15, both P < 0.001).

Conclusion: For patients with dental anxiety, remimazolam offers not only faster recovery, but also a much better restoration of memory function compared with midazolam.

Keywords

Adult, Female, Humans, Male, Middle Aged, Young Adult, Benzodiazepines, Dental Anxiety, Memory, Midazolam, Tooth Extraction, antegrade amnesia, benzodiazepine, outpatient surgery, procedure sedation, remimazolam, besylate

Comments

Trial registration: https://clinicaltrials.gov/study/NCT05350085.

Published Open-Access

yes

Recommended Citation

Jing, Quan; Wang, Weijia; Wu, Limeng; et al., "A Comparison of the Effect of Remimazolam and Midazolam on Recovery and Preserved Memory Function for Patients with Dental Extraction Anxiety" (2025). Faculty, Staff and Student Publications. 1539.
https://digitalcommons.library.tmc.edu/uthsph_docs/1539