IV Midazolam Titration — ORE Part 1 MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: D — Give 2 mg IV slowly, then 0.5–1 mg IV after 2 minutes if required
Explanation lettering: D = shown as A · E = shown as C · A = shown as D · C = shown as E
A is correct. For a healthy adult, midazolam for conscious sedation should be given slowly and titrated to clinical response: 2 mg IV over about 30 seconds, followed—if sedation remains inadequate after 2 minutes—by 0.5–1 mg increments. SDCEP specifies titrated IV midazolam as the standard dental technique and considers fixed-dose or bolus methods unacceptable. B and C use excessive fixed starting doses, increasing the risk of oversedation. D has an appropriate initial quantity but is unsafe because rapid administration is inappropriate and subsequent doses are too large. E combines a fixed high initial dose with rapid injection. The endpoint is conscious sedation, with maintained verbal responsiveness, not a predetermined total dose.
Reference: Scottish Dental Clinical Effectiveness Programme. Conscious Sedation in Dentistry, section 4.1.2 Intravenous Sedation with Midazolam, 2025. https://www.sdcep.org.uk/media/iegenn4c/sdcep-conscious-sedation-guidance.pdf