title: Midazolam-fentanyl analgo-sedation in pediatric dental patients--a pilot study.
abstract: OBJECTIVE
  The objective of this study was to comparatively evaluate the effectiveness ofsubmucosalfentanyl when administered in conjunction with oral midazolam during pediatric procedural sedations.
  
  
  METHODS
  Twenty three uncooperative ASA type I children who met the selection criteria were randomly assigned to receive either submucosal fentanyl (3 microg/kg) or placebo, along with oral midazolam (0.5 mg/kg). A triple blind, 2-stage cross-over design was adopted so that each child received both the regimens.
  
  
  RESULTS
  Transient oxygen desaturation was observed in 4 children who were sedated with the combination of oral midazolam and submucosalfentanyl. The overall success was 73.91% with oral midazolam and submucosal fentanyl regimen and 47.83% for oral midazolam and submucosal placebo regimen. The chances of 'satisfactorily'completing a 45 minute dental procedure in an uncooperative pediatric patient was 2.8 times more, when submucosalfentanyl was used along with oral midazolam.
  
  
  CONCLUSIONS
  Submucosal fentanyl appears to improve the short working time associated with oral midazolam. But the oxygen desaturation associated with this regimen necessitates further studies to evaluate the efficacy of this combination at relatively lower doses before being used routinely for pediatric procedural sedation and analgesia.
authors.affiliation: Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, C.S.M. Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: R K
authors.initials: RK
authors.lastname: Pandey
authors.forename: M Y
authors.initials: MY
authors.lastname: Padmanabhan
authors.forename: A K
authors.initials: AK
authors.lastname: Saksena
authors.forename: Girish
authors.initials: G
authors.lastname: Chandra
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000284:Administration, Oral; D000766:Anesthesia, Dental; D000779:Anesthetics, Local / Q000008:administration & dosage; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D016292:Procedural Sedation; D003299:Cooperative Behavior; D018592:Cross-Over Studies; D054810:Deep Sedation; D003785:Dental Pulp Capping; D003793:Dental Restoration, Permanent; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D009061:Mouth Mucosa; D010865:Pilot Projects; D010919:Placebos; D011672:Pulpotomy; D016896:Treatment Outcome
chemical_list: D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D010919:Placebos; D008012:Lidocaine; D008874:Midazolam; D005283:Fentanyl