title: [Clinical evaluation of midazolam intravenous sedation under bispectral index monitoring on romoval of anterior supernumerary teeth in children].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of midazolam intravenous sedation plus local anaesthesia on romoval of children's anterior supernumerary teeth in dental clinic.
  
  
  METHODS
  A total of 41 ASA I children with anterior supernumerary teeth aged 6 to 14 were selected for removal surgery, anaesthesia was done by moderate sedation by midazolam intravenous titration plus local anaesthesia. Heart rate (HR), blood pressure (BP), pulse oxygen saturation rate (SpO(2)), bispectral index (BIS) and Ramsay sedation score (RSS) at different time points were recorded (5 min after patient is in operation room, at local anaesthesia injection, at incision, 10 min after incision and at the end of operation). After operation, the overall efficacy of sedation by Houpt rating scale was evaluated by surgeon, anaesthesiologist and anaesthetic nurse.
  
  
  RESULTS
  Among the 41 children, 29 were male, 12 were female, mean age (9.76 ± 2.46) years old; The average operation time was (23.83 ± 9.98) min, total dose of midazolam was (2.96 ± 0.92) mg with a dosage rate being (0.084 ± 0.016) mg/kg. There was a positive correlation between age and total dose (r=0.69, P<0.01); and a negative correlation between age and total dosage (r=-0.37, P<0.05). With the decreasing of age, probability for children to move or cry during local anaesthesia can increase, while with the increasing of age, probability for children to memorize the clicking of drill or hammer could increase. The correlation coefficient between RSS and BIS value was r=-0.854 (P<0.01), the median BIS value corresponded to RSS of 3 was 75. Pulse oxygen saturation rate was above 95% in all the cases.
  
  
  CONCLUSIONS
  Sedation by midazolam intravenous titration is a safe and efficient method of anesthesia for removal of children's anterior supernumerary teeth when BIS value is above 75.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Guan
authors.forename: En-bo
authors.initials: EB
authors.lastname: Wang
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.forename: Nian-hui
authors.initials: NH
authors.lastname: Cui
authors.forename: Bei
authors.initials: B
authors.lastname: Ding
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000766:Anesthesia, Dental; D000772:Anesthesia, Local; D002648:Child; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D014081:Tooth Extraction; D014096:Tooth, Supernumerary / Q000601:surgery*; D014097:Tooth, Unerupted
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam