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Intravenous sedation in pediatric dentistry using midazolam, nalbuphine and droperidol.
Pediatr Dent. 2000 Mar-Apr; 22(2):113-9.PD

Abstract

PURPOSE

The purpose of this pilot investigation was to study the efficacy, physiologic responses, and safety of a multi-drug intravenous conscious sedation technique in an outpatient setting in children who demonstrated uncooperative behavior when comprehensive restorative dental treatment was attempted.

METHODS

Using a time-based sedation record, the physiologic responses of 153 healthy children, age range 23 months to 14.5 years, were measured after they had received midazolam (Versed), nalbuphine (Nubain), and droperidol (Inapsine), each administered intravenously, and nitrous oxide and oxygen administered by nasal mask, while each child received comprehensive restorative or surgical dental care. Each patient was monitored according to the American Academy of Pediatrics Sedation Guidelines. Heart rate and rhythm, blood pressure, respiratory rate, hemoglobin oxygen saturation, end-tidal CO2, level of sedation, and behavioral responses were recorded preoperatively, at 5 minute intervals during treatment and in recovery until discharge. Sedation was titrated to Level 2 or 3 during treatment as defined by the American Academy of Pediatric Dentistry Reference Manual.

RESULTS

For each child, the sedation level was judged to be either acceptable or optimal for the completion of all planned dental treatment. There were no sedation failures. Children under 20 kg required significantly higher dosages of each sedative medication than children more than 20 kg to achieve the same level of sedation (P < 0.001, ANOVA). There were no episodes of intraoperative vomiting, hypotension, cardiac arrhythmias, respiratory depression requiring respiratory support, or dysphoria during treatment, in the recovery period, or after discharge.

CONCLUSION

This multi-drug intravenous conscious sedation technique is a safe and effective method to control the behavior of uncooperative children who require comprehensive dental treatment.

Authors+Show Affiliations

Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.angelmanguel@home.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

10769855

Citation

Milnes, A R., et al. "Intravenous Sedation in Pediatric Dentistry Using Midazolam, Nalbuphine and Droperidol." Pediatric Dentistry, vol. 22, no. 2, 2000, pp. 113-9.
Milnes AR, Maupomé G, Cannon J. Intravenous sedation in pediatric dentistry using midazolam, nalbuphine and droperidol. Pediatr Dent. 2000;22(2):113-9.
Milnes, A. R., Maupomé, G., & Cannon, J. (2000). Intravenous sedation in pediatric dentistry using midazolam, nalbuphine and droperidol. Pediatric Dentistry, 22(2), 113-9.
Milnes AR, Maupomé G, Cannon J. Intravenous Sedation in Pediatric Dentistry Using Midazolam, Nalbuphine and Droperidol. Pediatr Dent. 2000 Mar-Apr;22(2):113-9. PubMed PMID: 10769855.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intravenous sedation in pediatric dentistry using midazolam, nalbuphine and droperidol. AU - Milnes,A R, AU - Maupomé,G, AU - Cannon,J, PY - 2000/4/19/pubmed PY - 2000/6/8/medline PY - 2000/4/19/entrez SP - 113 EP - 9 JF - Pediatric dentistry JO - Pediatr Dent VL - 22 IS - 2 N2 - PURPOSE: The purpose of this pilot investigation was to study the efficacy, physiologic responses, and safety of a multi-drug intravenous conscious sedation technique in an outpatient setting in children who demonstrated uncooperative behavior when comprehensive restorative dental treatment was attempted. METHODS: Using a time-based sedation record, the physiologic responses of 153 healthy children, age range 23 months to 14.5 years, were measured after they had received midazolam (Versed), nalbuphine (Nubain), and droperidol (Inapsine), each administered intravenously, and nitrous oxide and oxygen administered by nasal mask, while each child received comprehensive restorative or surgical dental care. Each patient was monitored according to the American Academy of Pediatrics Sedation Guidelines. Heart rate and rhythm, blood pressure, respiratory rate, hemoglobin oxygen saturation, end-tidal CO2, level of sedation, and behavioral responses were recorded preoperatively, at 5 minute intervals during treatment and in recovery until discharge. Sedation was titrated to Level 2 or 3 during treatment as defined by the American Academy of Pediatric Dentistry Reference Manual. RESULTS: For each child, the sedation level was judged to be either acceptable or optimal for the completion of all planned dental treatment. There were no sedation failures. Children under 20 kg required significantly higher dosages of each sedative medication than children more than 20 kg to achieve the same level of sedation (P < 0.001, ANOVA). There were no episodes of intraoperative vomiting, hypotension, cardiac arrhythmias, respiratory depression requiring respiratory support, or dysphoria during treatment, in the recovery period, or after discharge. CONCLUSION: This multi-drug intravenous conscious sedation technique is a safe and effective method to control the behavior of uncooperative children who require comprehensive dental treatment. SN - 0164-1263 UR - https://www.unboundmedicine.com/medline/citation/10769855/Intravenous_sedation_in_pediatric_dentistry_using_midazolam_nalbuphine_and_droperidol_ L2 - https://medlineplus.gov/childdentalhealth.html DB - PRIME DP - Unbound Medicine ER -