title: The Use of Intranasal Midazolam in a Special Care Dentistry Department: Technique and Cases.
abstract: Intranasal (IN) administered midazolam has allowed patients who require conscious sedation but struggle to tolerate cannulation another option by which they can receive dental treatment. Studies have demonstrated that a mean bioavailability (F) of more than 73% can be achieved with IN-administered midazolam. This is due to the high vascularity within the nose. These studies have also demonstrated that peak plasma concentrations can be reached within 10 minutes. This signifies a fast onset of action. The standard bolus dose of IN midazolam is 10mg; this bolus can be reduced or increased depending on the patient's age and susceptibility to benzodiazepines. The bolus can also be repeated if adequate sedation is not reached. A protocol for administering IN midazolam is outlined and two cases are discussed.
authors.affiliation: Special care dentistry, Dorset County Hospital, Dorchester, USA.
authors.forename: David
authors.initials: D
authors.lastname: Drysdale
mesh_terms: D000281:Administration, Intranasal; D061605:Administration, Intravenous; D000293:Adolescent; D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods; D001682:Biological Availability; D016292:Procedural Sedation / Q000379:methods*; D003730:Dental Care for Persons with Disabilities; D003793:Dental Restoration, Permanent; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000493:pharmacokinetics; D008297:Male; D008874:Midazolam / Q000008:administration & dosage* / Q000493:pharmacokinetics; D014081:Tooth Extraction; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam