title: Optimising the dose of oral midazolam sedation for dental procedures in children: a prospective, randomised, and controlled study.
abstract: BACKGROUND
  Midazolam sedation poses a significant dilemma in paediatric dentistry, which is to find out the optimal dosing with minimal undesirable adverse events. In this study, we aimed to compare the effect of three doses of oral midazolam (0.5, 0.75, and 1 mg/kg) on the sedative state and cooperative behaviour of children during dental treatment. We further compared completion rates, parent satisfaction, and all adverse events.
  
  
  METHODS
  Ninety children aged 3-10 years were randomised to three equal groups. Groups A, B, and C received 0.5, 0.75, and 1 mg/kg of oral midazolam, respectively. Levels of sedation, cooperative behaviour, procedures completion rates, parent satisfaction, and adverse events were prospectively recorded.
  
  
  RESULTS
  Sedation scores in B and C were higher (P < 0.001) than in A. Cooperation scores (CS) in B and C were higher (P < 0.001) than in A. Significant increase in completion rates was observed between A and C (P = 0.025). Parent satisfaction was greater in B and C (P < 0.001) compared to A. Adverse events were higher in C (P < 0.05) than in A or B.
  
  
  CONCLUSIONS
  Amount of 0.75 mg/kg oral midazolam appears to be the optimal oral dose in terms of effectiveness, acceptability, and safety for dental treatments in paediatric patients, when administered by an experienced, paediatric anaesthetist.
authors: Anaesthesia Department, Bnai Zion Medical Center, Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel.
authors: Mostafa
authors: M
authors: Somri
authors: Constantinos A
authors: CA
authors: Parisinos
authors: Johny
authors: J
authors: Kharouba
authors: Naomi
authors: N
authors: Cherni
authors: Ami
authors: A
authors: Smidt
authors: Zackariya
authors: Z
authors: Abu Ras
authors: Geith
authors: G
authors: Darawshi
authors: Luis A
authors: LA
authors: Gaitini
mesh_terms: D000284:Administration, Oral; D000766:Anesthesia, Dental / Q000009:adverse effects / Q000379:methods*; D001794:Blood Pressure / Q000502:physiology; D002648:Child; D002652:Child Behavior / Q000187:drug effects; D002675:Child, Preschool; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods*; D003299:Cooperative Behavior; D019140:Dental Care for Children / Q000706:statistics & numerical data; D003812:Dentist-Patient Relations; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D008874:Midazolam / Q000008:administration & dosage* / Q000009:adverse effects; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000097:blood; D010290:Parents / Q000523:psychology; D010351:Patient Discharge; D010549:Personal Satisfaction; D011446:Prospective Studies; D012119:Respiration; D012149:Restraint, Physical; D012449:Safety; D016037:Single-Blind Method; D013997:Time Factors
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam; D010100:Oxygen