Conscious sedation--an artist's science! An Indian experience with midazolam.
The present study was undertaken to evaluate Midazolam as a Paediatric conscious sedative agent for a routine Indian dental setup and to compare its efficacy and safety when administered by intranasal and intramuscular routes, at a dosage of 0.2 mg/kg body weight. The present study was accomplished in two phases: Phase 1: Preliminary dose finding pilot study on 10 children. Phase 2: Single dose, randomized parallel clinical trial on 40 children between the ages of 2 and 5 years. These children were randomly assigned to two groups consisting of 20 subjects each. Group M, received Midazolam intramuscularly, while Group N received Midazolam intranasally. Both the intranasal and intramuscular groups showed highly significant decrease in crying levels, motor movements and sensory perception levels, post-sedation (P P < 0.001). Midazolam could be safely and successfully employed by intranasal and intramuscular routes for Paediatric conscious sedation in a routine dental setup with basic facilities at a dosage of 0.2 mg/ kg body weight. Whenever the clinical situation warrants a faster action, peak and recovery, the intranasal route should be the obvious choice.
Department of Paediatric Dentistry College of Dental Sciences, Davanagere, Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore, India.
N D
ND
Shashikiran
Subba V V
SV
Reddy
C M
CM
Yavagal
D000281:Administration, Intranasal; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental; D001835:Body Weight; D002652:Child Behavior / Q000187:drug effects; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods*; D003371:Cough / Q000139:chemically induced; D003448:Crying; D005260:Female; D006606:Hiccup / Q000139:chemically induced; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007273:Injections, Intramuscular; D008297:Male; D008874:Midazolam / Q000008:administration & dosage* / Q000009:adverse effects; D009043:Motor Activity / Q000187:drug effects; D010865:Pilot Projects; D012449:Safety; D016037:Single-Blind Method; D012912:Sneezing / Q000187:drug effects; D013997:Time Factors; D014851:Wakefulness / Q000187:drug effects
D006993:Hypnotics and Sedatives; D008874:Midazolam