Comparison of Drug Acceptance and Anxiety Between Intranasal and Sublingual Midazolam Sedation.
OBJECTIVE
The purpose of the study was to assess and compare the changes in anxiety level and drug acceptance after intranasal and sublingual midazolam sedation.


METHODS
Forty three- to seven-year-olds were randomly assigned to Group A (N equals 20; 0.2 mg/kg intranasal midazolam sedation) or Group B (N equals 20; 0.2 mg/kg sublingual midazolam sedation) sedation. The anxiety levels at various time periods were assessed from recorded videos using the Venham clinical anxiety scale by two pediatric dentists. The acceptance of the drug administration was assessed using a four-point scale. The Wilcoxon signed rank test and Mann-Whitney U test were used for statistical analysis using SPSS 17.0 software.


RESULTS
There was a significant decrease in anxiety level from baseline to 20 minutes after drug administration in Group A (P<0.001) and Group B (P<0.001). However, there was no significant difference in the anxiety level between the two groups. The sublingual route of drug administration was better accepted (P=0.001) than the intranasal route of drug administration.


CONCLUSIONS
Both intranasal and sublingual administrations of midazolam were equally effective in reducing the child's anxiety. The sublingual route of drug administration was better accepted than the intranasal route.
Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India.
A Karthikeyan
AK
Shanmugaavel
Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, KSR Kalvi Nagar, Tiruchengode, Tamil Nadu, India. asokansharath@yahoo.com.
Sharath
S
Asokan
Department of Pedodontics and Preventive Dentistry, Vinayaka Mission's Sankarachariyar Dental College, Salem, Tamil Nadu, India.
J Baby
JB
John
Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, KSR Kalvi Nagar, Tiruchengode, Tamil Nadu, India.
P R Geetha
PR
Priya
Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, KSR Kalvi Nagar, Tiruchengode, Tamil Nadu, India.
M Thirumalai
MT
Raaja
D000281:Administration, Intranasal; D000286:Administration, Sublingual; D001007:Anxiety; D002648:Child; D016292:Procedural Sedation; D006801:Humans; D006993:Hypnotics and Sedatives; D008874:Midazolam
D006993:Hypnotics and Sedatives; D008874:Midazolam