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.
Shashikiran
N D
ND
Department of Paediatric Dentistry College of Dental Sciences, Davanagere, Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore, India.
Reddy
Subba V V
SV
Yavagal
C M
CM
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