Anxiolysis

Anxiolysis is a pharmacologic and non-pharmacologic approach aimed at reducing anxiety and apprehension associated with medical or dental procedures, with the goal of achieving minimal sedation. In this state, the patient is calm, cooperative, and responsive to verbal commands, while airway reflexes and overall cardiorespiratory function are preserved.

In medical and dental practice, anxiolysis often denotes a level of sedation lighter than conscious sedation. The term is used alongside minimal sedation and anxiolytic therapy. The American Society of Anesthesiologists defines minimal sedation (anxiolysis) as a drug-induced state during which the patient responds normally to verbal commands; cognitive function and coordination may be affected, but ventilatory and cardiovascular functions are unaffected.

Common pharmacologic options include benzodiazepines given orally or intranasally (and less commonly intravenously), such as midazolam, diazepam, or lorazepam, which reduce anxiety and may impair memory of the procedure. Nitrous oxide–oxygen inhalation is another widely used anxiolytic method, particularly in dentistry. Non-pharmacologic strategies—such as patient education, relaxation techniques, guided imagery, and music therapy—are often used alone or in combination with drugs.

Indications include procedures that provoke significant anxiety or distress, fear of needles or noises, or the need for patient cooperation with minimal disruption of protective reflexes. Safety relies on appropriate monitoring, staff trained in sedation, and equipment ready for airway management. Adverse effects can include drowsiness, impaired coordination, amnesia, and, with certain agents, potential respiratory depression or drug interactions. Anxiolysis represents the mildest end of the sedation spectrum, emphasizing anxiety reduction while preserving safety and responsiveness.