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Optimising the dose of oral midazolam sedation for dental procedures in children: a prospective, randomised, and controlled study
Author(s) -
SOMRI MOSTAFA,
PARISINOS CONSTANTINOS A.,
KHAROUBA JOHNY,
CHERNI NAOMI,
SMIDT AMI,
ABU RAS ZACKARIYA,
DARAWSHI GEITH,
GAITINI LUIS A.
Publication year - 2012
Publication title -
international journal of paediatric dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.183
H-Index - 62
eISSN - 1365-263X
pISSN - 0960-7439
DOI - 10.1111/j.1365-263x.2011.01192.x
Subject(s) - medicine , midazolam , sedation , adverse effect , dosing , sedative , anesthesia , patient satisfaction , prospective cohort study , randomized controlled trial , surgery
International Journal of Paediatric Dentistry 2012; 22: 271–279 Background. Midazolam sedation poses a significant dilemma in paediatric dentistry, which is to find out the optimal dosing with minimal undesirable adverse events. In this study, we aimed to compare the effect of three doses of oral midazolam (0.5, 0.75, and 1 mg/kg) on the sedative state and cooperative behaviour of children during dental treatment. We further compared completion rates, parent satisfaction, and all adverse events. Design. Ninety children aged 3–10 years were randomised to three equal groups. Groups A, B, and C received 0.5, 0.75, and 1 mg/kg of oral midazolam, respectively. Levels of sedation, cooperative behaviour, procedures completion rates, parent satisfaction, and adverse events were prospectively recorded. Results. Sedation scores in B and C were higher ( P < 0.001) than in A. Cooperation scores (CS) in B and C were higher ( P < 0.001) than in A. Significant increase in completion rates was observed between A and C ( P = 0.025). Parent satisfaction was greater in B and C ( P < 0.001) compared to A. Adverse events were higher in C ( P < 0.05) than in A or B. Conclusion. Amount of 0.75 mg/kg oral midazolam appears to be the optimal oral dose in terms of effectiveness, acceptability, and safety for dental treatments in paediatric patients, when administered by an experienced, paediatric anaesthetist.