title: A study of the effectiveness of oral midazolam as a dental pre-operative sedative and hypnotic.
abstract: Orally administered Midazolam at dosages of 0.5, 0.6, and 0.75 mg/kg was used with 34 healthy, uncooperative pediatric dental patients. Effective pre-operative sedation occurred within approximately 15 minutes with a 30- to 40-minute duration of action. Blood pressure and respiration remained stable throughout. The numbers and types of procedures performed were dependent on the degree of sedation, the behavior of the patient, the experience of the operator, and the operator's ability to administer the medication. The ideal dosage appears to be 0.6 mg/kg, with an average change of 1.43 Frankel Units in behavior modification. A dosage of 0.5 mg/kg appears to yield erratic results, while a dosage of 0.75 mg/kg offers little advantage with greater potential for adverse reactions. The oral administration of Midazolam for pediatric patients with extreme behavioral problems, such as Attention Deficit Hyperactive Disorder, was of little advantage and may produce an idiosyncratic reaction. Midazolam's quick onset and short duration of action, coupled with its ideal properties of sedation, relaxation, and amnesia, offer a viable alternative for treating the anxious, uncooperative pediatric dental patient.
authors.affiliation: WVU School of Dentistry, Department of Oral and Maxillofacial Surgery and Hospital Dentistry, Morgantown, WV 26506, USA.
authors.forename: W R
authors.initials: WR
authors.lastname: Marshall
authors.forename: B D
authors.initials: BD
authors.lastname: Weaver
authors.forename: P
authors.initials: P
authors.lastname: McCutcheon
mesh_terms: D000284:Administration, Oral; D000766:Anesthesia, Dental; D014151:Anti-Anxiety Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001289:Attention Deficit Disorder with Hyperactivity / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002652:Child Behavior / Q000187:drug effects; D002675:Child, Preschool; D016292:Procedural Sedation; D003299:Cooperative Behavior; D016854:Dental Anxiety / Q000517:prevention & control*; D003729:Dental Care / Q000523:psychology; D003793:Dental Restoration, Permanent; D003812:Dentist-Patient Relations; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000493:pharmacokinetics; D007223:Infant; D008874:Midazolam / Q000008:administration & dosage* / Q000493:pharmacokinetics; D012119:Respiration / Q000187:drug effects; D013223:Statistics as Topic; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D008874:Midazolam