Evaluating remimazolam for safe and effective sedation in older special care patients

Title: Evaluating remimazolam for safe and effective sedation in older special care patients

Abstract:

Background: An increasing number of older patients with multimorbidity and cognitive conditions will need dental care under IV sedation and present challenges for dental sedation due to increased sensitivity to sedative agents. Traditionally, midazolam is used for intravenous sedation, and older patients require a slower titration. With its rapid onset and shorter halflife, remimazolam may offer an alternative to midazolam with a potential reduced respiratory depression and faster recovery.
Aims:
1.Evaluate the efficacy and safety of single-drug IVS with remimazolam for patients aged 60 and above with multimorbidity in a district general hospital dental unit.
2.Identify the patient groups sedated, their treatment outcomes, and if any complications occurred.
Method: Data from an intravenous sedation logbook was analysed for patients aged 60 and over. Information collected included: 2 patient age, ellis grade, ASA grade, total remimazolam dose, dental treatment provided, complications and operator feedback.
Results: Ten cases were identified. Treatments were completed with no adverse events or complications. Procedures were generally short with quick recovery. No cases required the use of flumazenil.
Abstract Submission Template
Discussion: Remimazolam demonstrated advantages over midazolam for brief dental procedures, including reduced respiratory depression, rapid recovery, and minimal adverse effects. While remimazolam costs significantly more than midazolam, its safety profile and efficacy for older patients with complex medical needs make it a valuable sedative option in special care dentistry.

Biography:

Thushara Thayaparan graduated with a Bachelor of Dental Surgery (BDS) with Honours from King’s College London in 2021. Following graduation, she completed Foundation Training in General practice, where she developed a strong foundation in comprehensive patient care. She then undertook Dental Core Training Year 1 gaining experience in Oral and Maxillofacial Surgery as well as Special Care Dentistry and in the Community Dental Services. Thayaparan subsequently worked within Community Dental Services in Surrey, managing paediatric and special care patients, including those with complex medical, behavioural, and additional needs. She is currently a Specialty Trainee (ST1) in Special Care Dentistry Surrey and London. Through her training, she has developed a broad clinical skill set in both hospital and community-based dentistry, with a particular interest in the management of medically complex and vulnerable patient groups.