The effects of midazolam on pediatric patients with asthma.
OBJECTIVE
This study was performed to evaluate the safety and efficacy of midazolam in asthmatic patients undergoing dental treatment.


METHODS
Twenty-four children, aged 19 to 65 months, with a diagnosis of mild to moderate asthma were given an oral dose of 0.5 mg/kg of midazolam. Oxygen saturation, respiratory rate, and pulse rate were monitored before, during, immediately after, and 30 minutes following dental treatment. The child's asthma score was also determined before and after treatment. The dental operator assessed the overall sedation outcome immediately after treatment.


RESULTS
Twenty-three of the 24 subjects had asthma scores of "0" before and after treatment. During dental treatment, 2 patients had oxygen saturations of 94% at one point during treatment. However, oxygen saturation increased when the patient's head and neck were repositioned. Twenty-three of the 24 subjects had oxygen saturations above 95% at 30 minutes following treatment. Pulse rates and respiratory rates exhibited transitory increases, linked to when the child was stimulated. Statistical analysis was conducted from within subjects repeated measures via ANOVA and with a general linear model approach. No statistically significant differences occurred in oxygen saturation and respiratory rate. However, significant differences did occur in pulse rate between 5 and 10 minutes (mean difference=10+/-3.84) and between 10 and 15 minutes (mean difference=19+/-5.50), as expected. No statistically significant differences occurred in asthma score before and after treatment. Twelve subjects were assessed to have excellent behavior, 5 subjects were satisfactory, and 7 subjects were unsatisfactory. No treatment was aborted.


CONCLUSIONS
With adherence to the AAPD's sedation guidelines, midazolam at a dose of 0.5 mg/kg is a safe and effective mean for sedation of patients with mild to moderate asthma.
Kil
Nancy
N
Pediatric Dental Residency Program, Children's Hospital of Michigan/Detroit Medical Center, and Wayne State University, School of Medicine, USA.
Zhu
Jian-Fu
JF
VanWagnen
Catherine
C
Abdulhamid
Ibrahim
I
D000704:Analysis of Variance; D000766:Anesthesia, Dental / Q000379:methods*; D001249:Asthma; D002652:Child Behavior / Q000187:drug effects; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods*; D017742:Dental Care for Chronically Ill; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology*; D007223:Infant; D016014:Linear Models; D008297:Male; D008874:Midazolam / Q000494:pharmacology*; D010100:Oxygen / Q000097:blood; D011229:Preanesthetic Medication; D012119:Respiration / Q000187:drug effects
D006993:Hypnotics and Sedatives; D008874:Midazolam; D010100:Oxygen