INTRODUCTION: Dental anxiety is a prevalent issue among patients undergoing minor oral surgical procedures such as extractions, biopsies, and implant placement. This study aimed to evaluate the impact of oral alprazolam as a premedicative anxiolytic agent on vital parameters, including pulse rate (PR), systolic and diastolic blood pressure (SBP and DBP, respectively), respiratory rate (RR), and oxygen saturation (SpO2), in patients undergoing minor oral surgeries. MATERIALS AND METHODS: A quasi-experimental study was conducted on patients aged 18-45 years who required minor oral surgical procedures under local anesthesia (LA) and were divided into two groups based on the Dental Anxiety Scale (DAS) scores. Group 1 (anxious
DAS score >
11) received 0.25 mg oral alprazolam 30 minutes pre-operatively, while Group 2 (non-anxious/mildly anxious
DAS score <
10) underwent surgery without alprazolam. Vital parameters were recorded at three intervals: preoperatively (T0), intraoperatively (15 minutes after starting surgery
T1), and postoperatively (30 minutes after surgery
T2). Statistical analyses included independent t-tests and logistic regression analyses to evaluate differences and associations. RESULTS: A significant reduction in PR, RR, and SBP was observed in Group 1 across all intervals, compared to Group 2, indicating the effectiveness of alprazolam in stabilizing physiological responses. Postoperative SpO₂ levels remained unaffected in both groups, ensuring patient safety. Logistic regression analysis revealed that elevated preoperative PR, SBP, and RR were significant predictors of anxiety, highlighting their role in identifying candidates for anxiolytic premedication. CONCLUSION: Premedication with 0.25 mg oral alprazolam effectively alleviated anxiety and stabilized vital parameters during minor oral surgeries, thereby enhancing patient comfort and procedural efficacy. These findings emphasize the importance of incorporating anxiolytic strategies into dental practice to optimize patient care and surgical outcomes. Future studies should explore different doses and broader populations to refine the anxiolytic interventions.