Comparison of oral midazolam with a combination of oral midazolam and nitrous oxide-oxygen inhalation in the effectiveness of dental sedation for young children.
OBJECTIVE
To compare the effectiveness of 0.6 mg/kg oral midazolam sedation alone and a combination of 0.6 mg/kg oral midazolam plus nitrous oxide-oxygen inhalation sedation, in controlling the behavior of uncooperative children during dental treatment.


METHODS
The study had a crossover design where the same patient received two different sedation regimens, that is, oral midazolam 0.6 mg/kg and oral midazolam 0.6 mg/kg with nitrous oxide-oxygen inhalation during two dental treatment visits.


METHODS
Thirty children (17 males and 13 females) were randomly selected for the study, with a mean age of 55.07 (+/- 9.29) months, ranging from 48 - 72 months. A scoring system suggested by Houpt et al. (1985) was utilized for assessment of the children's behavior.


RESULTS
There was no significant (p > 0.05) difference in the overall behavior assessment between the two sedation regimens, that is, oral midazolam alone and oral midazolam plus nitrous oxide-oxygen. However, the combination of midazolam and nitrous oxide-oxygen showed significantly (p < 0.05) superior results as compared to midazolam alone, in terms of controlling movement and crying during local anesthesia administration and restorative procedures.


CONCLUSIONS
Compared to oral midazolam alone, a combination of oral midazolam and nitrous oxide inhalation sedation appears to provide more comfort to pediatric dental patients and operators during critical stages of dental treatment.
Al-Zahrani
A M
AM
Security Forces Hospital, Makkah Al-Mukarrama, Saudi Arabia.
Wyne
Amjad H
AH
Sheta
S A
SA
D000284:Administration, Oral; D000766:Anesthesia, Dental / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D018685:Anesthetics, Inhalation; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods*; D018592:Cross-Over Studies; D003448:Crying; D019140:Dental Care for Children; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D009068:Movement; D009609:Nitrous Oxide / Q000008:administration & dosage*
D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D009609:Nitrous Oxide; D008874:Midazolam