Special care dentistry: Midazolam conscious sedation for patients with neurological diseases.
OBJECTIVE
Midazolam is used very often to control the anxiety of patients for dental treatment, especially in patients with special needs. The objective of this study was to evaluate the efficiency of Midazolam in patients with neurological diseases referred for dental treatment.


METHODS
Descriptive study.


METHODS
Forty consecutive patients with neurological disorders (encephalopathy, autism, and epilepsy) were referred to dental treatment, and 45 sedations were performed; all were sedated with Midazolam (intramuscular 0.2-0.3 mg/kg or intravenous 0.1mg/kg) and all were anesthetised with lidocaine 2% (0.5-2 mL). During the dental procedure, their behavior was analysed and classified into 3 categories: A (indifferent), B (reacted but allowed treatment), and C (did not allow treatment). Data were tabbed and statistically analysed.


RESULTS
The final patients' classification was: A 22 (49%), B 18 (40%) and C 5 (11%); the patients with encephalopathy had the best results of sedation according to the proposed classification (p<0.05).


CONCLUSIONS
Midazolam demonstrated to be effective in 89% of this sample for dental procedures in patients with neurological and behavioral disturbances, but it was less effective for patients with autism (p<0.05).
Dentistry Division, Hospital das Clinicas, Medical School, University of Sao Paulo, Brazil.
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Capp
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de Faria
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Siqueira
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Cillo
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Prado
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D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D001321:Autistic Disorder; D001925:Brain Damage, Chronic; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods*; D017742:Dental Care for Chronically Ill; D004827:Epilepsy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D009422:Nervous System Diseases; D055815:Young Adult
D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D008012:Lidocaine; D008874:Midazolam