Nationwide trends in intravenous sedative and analgesic drug use in Korean dental institutions: a big data analysis using the Narcotics Information Management System from 2020 to 2024.

BACKGROUND

Intravenous (IV) sedation is an effective method of alleviating patient anxiety and pain, thereby improving cooperation during dental procedures. In South Korea, most drugs used for IV sedation are classified as psychotropic substances, which require strict management throughout the processes of administration, storage, and disposal. In 2018, all medical institutions in Korea were mandated to report on the manufacture, import, use, administration, and disposal of narcotic and psychotropic drugs to the Narcotics Information Management System (NIMS). Thus, in this study, we aimed to analyze the current status and trends of narcotic and psychotropic drug use in IV sedation performed at domestic dental clinics and hospitals by year, region, sex, and age using the aforementioned big data.

METHODS

Data on narcotic and psychotropic drug use reported nationwide by dental clinics and hospitals between January 2020 and December 2024 were collected. The drugs analyzed included midazolam, propofol, ketamine, and remimazolam (used for intravenous sedation), as well as fentanyl, remifentanil, and pethidine (used as analgesic adjuncts). Annual trends, regional distributions, and usage ratios by age and sex were analyzed for these medications.

RESULTS

During the analysis period, the use of intravenous sedatives in domestic dental practice showed a continuous annual increase. As of 2024, midazolam account for the largest share, at approximately 76.5% of the total sedative use, followed by propofol (10.6%), ketamine (9.9%), and remimazolam (2.8%). Notably, ketamine showed the most rapid growth, with its annual usage increasing by approximately 152% in 2023 compared to the previous year. According to the type of medical institution, the volume of sedatives used in dental clinics account for 90.8% of the sedatives in 2024, indicating a higher growth rate in dental clinics than in dental hospitals. The average annual growth rate of sedative use is high among adults. Regionally, usage tends to become increasingly concentrated in the Seoul Metropolitan Area (Seoul and Gyeonggi).

CONCLUSION

The use of IV sedation in Korean dentistry is consistently increasing. Safe IV sedation methods, primarily involving midazolam, are being widely implemented for adults in dental clinic settings.