A retrospective audit to evaluate the effect of the change in midazolam concentration from 10 mg/5 ml to 5 mg/5 ml ampoules on midazolam doses given to sedation patients following the rapid response report (RRR).

Abstract

Unlabelled: The technique of intravenous sedation with a benzodiazepine is a well documented and successful method for reducing fear and anxiety in many patients who regard dental treatment as challenging and potentially painful. One of the most important factors to achieving a well sedated patient is ensuring the dose of the drug given is titrated to the individual patient. Five years ago, a Rapid Response Report issued by the National Patient Safety Agency changed the concentration of midazolam within a 5 ml ampoule from 10 mg/5 ml to 5 mg/5 ml. A retrospective audit of 300 patients undergoing oral surgery treatment under intravenous midazolam sedation at Birmingham Dental Hospital was carried out over a 6-month period to assess whether this difference in midazolam concentration had any influence on the average dose of midazolam given to these patients.

Study group: The midazolam doses given by five clinicians were audited both before and after the concentration change.

Results: the mean midazolam dose that was administered by three clinicians decreased following the change in concentration. In addition, the number of patients given greater than 5 mg midazolam following the change decreased with all five clinicians.

Conclusions: The change in midazolam concentration from 10 mg/5 ml to 5 mg/5 ml ampoules has resulted in the overall average dose of midazolam given by five clinicians at Birmingham Dental Hospital to decrease.