Abstract
The current study compares intranasal and oral midazolam for effect on sedation for patients requiring dental procedure. Eighty subjects between the ages of 5 and 12 years were received randomly either intranasal (0.2 mg/kg) or oral (0.5 mg/kg) midazolam. The observer assessed the children for sedation level at the following time points: Immediately before the drug was administered, and 20 and 30 min after drug administration. There were significant differences in sedation level among the both groups at the time of parental separation and at the time of induction. 39 (97.5%) and 40 (100%) of the forty patients who received oral midazolam were calm, drowsy or asleep at 20 and 30 min after drug administration, respectively. For patients who received intranasal midazolam, 32 (80%) and 33 (82.5%) of the forty patients were either calm or drowsy at 20 and 30 min after drug administration, respectively. None of the patients from the intranasal group was rated as ‘asleep’. Oral midazolam was found to be statistically more effective in providing a better sedation level at the time of parental separation and at the time of induction than intranasal administration. Our findings indicate a tendency for oral midazolam to be more effective as a premedication in children before general anesthesia. Key words: Preoperative, midazolam, sedation, anesthesia, pediatrics.
Highlights
The pre-anesthetic management in pediatric patients undergoing extensive dental treatment may be a challenge, during parental separation and induction of anesthesia
MDZ is a potent, short-acting benzodiazepine sedative hypnotic, which has been used as a premedication for general anesthesia and routinely used in pediatric dentistry for dental procedures
Studies by Kogan et al (2002) and Yildirim et al (2006). Found that both intranasal and oral midazolam produces good levels of sedation and anxiolysis, but no significant difference in the effects of sedation was observed between the oral midazolam group and the intranasal midazolam group
Summary
The pre-anesthetic management in pediatric patients undergoing extensive dental treatment may be a challenge, during parental separation and induction of anesthesia. MDZ is a potent, short-acting benzodiazepine sedative hypnotic, which has been used as a premedication for general anesthesia and routinely used in pediatric dentistry for dental procedures Midazolam has been used as a preoperative sedative agent via the intramuscular (Taylor et al, 1986), intranasal (Hartgraves and Primosch, 1994), oral (Hartgraves and Primosch, 1994; Cox et al, 2006), and rectal (Saint-Maurice et al, 1986) routes. Mean duration of anesthesia (min) Oral 7.12(1.713)
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