J Oral Maxillofac Surg. 1996 May;54(5):578-81; discussion 581-2.
Methohexital (Brevital) infusion technique for conscious sedation.
Johns FR, Ziccardi VB, Buckley M.
Department of Oral and Maxillofacial Surgery, University of Pittsburgh Medical Center, PA 15213, USA.
The purpose of this study was to evaluate a methohexital infusion technique for conscious sedation in oral surgical procedures. Patients were evaluated for recall, comfort, recovery, and surgeon’s estimate of cooperation.
MATERIALS AND METHODS:
Twenty adult (mean age, 29 years) ASA I or II patients requiring various dentoalveolar procedures were entered into the study. Administration of 1.5 micrograms/kg fentanyl and 1 mg midazolam were given until sedation was achieved. An infusion of methohexital was started using 50 micrograms/kg/min and increased as needed to 75 micrograms/kg/min. Postoperatively, visual analog scales were used to evaluate the efficacy of the technique.
The average total amount of methohexital infused was 257 mg for an average surgical time of 88 minutes. Recovery times were short and uneventful. Patients were cleared for discharge in under 35 minutes. No cardiac or respiratory side effects were noted other than a mild increase ( < 15%) in heart rate. Shivering and hiccoughing were noted in two and four cases, respectively. Recall of surgical events reported by patients was low and patient cooperation was high as reported by surgeons.
The continuous infusion of methohexital for conscious sedation has been shown to be safe, effective, inexpensive, and well accepted by patients and surgeons.