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Comparison of transmucosal midazolam with inhalation sedation for dental extractions in children. A randomized, cross-over, clinical trial.
Acta Anaesthesiol Scand. 2007 Sep; 51(8):1062-7.AA

Abstract

BACKGROUND

The transmucosal route for conscious sedation in children has been reported widely in the field of medicine, but less so in dental patients. The aim of this study was to evaluate the efficacy and safety profile of midazolam (0.2 mg/kg) administered by the buccal transmucosal route, in comparison with nitrous oxide/oxygen inhalation sedation, for orthodontic extractions in 10-16-year-old dental patients.

METHODS

Each patient attended for two visits and was randomly allocated to receive buccal midazolam (0.2 mg/kg) or nitrous oxide/oxygen titrated to 30%/70% at the first visit, the alternative being used at the second visit. The patients' vital signs, sedation levels and behavioural scores were recorded throughout. Post-operatively, side-effects, recall of the visit and satisfaction levels were recorded via questionnaire.

RESULTS

Thirty-six patients, with a mean age of 12.9 years, completed both arms of the trial. The maximum level of sedation was achieved with buccal midazolam in a mean time of 14.42 min, compared with 7.05 min with inhalation sedation. The vital signs with both types of sedation remained within acceptable limits and the reported side-effects were of no clinical significance. Buccal midazolam was found to be acceptable by 65.7%. Only 28.6% of cases preferred this technique, the main disadvantage being the taste of the solution.

CONCLUSION

Buccal midazolam sedation (0.2 mg/kg) seems to be equally as safe and effective as nitrous oxide/oxygen for the extraction of premolar teeth in anxious children. However, further research is required to refine the midazolam vehicle to improve acceptability.

Authors+Show Affiliations

Department of Sedation, Newcastle University School of Dental Sciences and Dental Hospital, Newcastle upon Tyne, UK. katherine.wilson@ncl.ac.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17697301

Citation

Wilson, K E., et al. "Comparison of Transmucosal Midazolam With Inhalation Sedation for Dental Extractions in Children. a Randomized, Cross-over, Clinical Trial." Acta Anaesthesiologica Scandinavica, vol. 51, no. 8, 2007, pp. 1062-7.
Wilson KE, Welbury RR, Girdler NM. Comparison of transmucosal midazolam with inhalation sedation for dental extractions in children. A randomized, cross-over, clinical trial. Acta Anaesthesiol Scand. 2007;51(8):1062-7.
Wilson, K. E., Welbury, R. R., & Girdler, N. M. (2007). Comparison of transmucosal midazolam with inhalation sedation for dental extractions in children. A randomized, cross-over, clinical trial. Acta Anaesthesiologica Scandinavica, 51(8), 1062-7.
Wilson KE, Welbury RR, Girdler NM. Comparison of Transmucosal Midazolam With Inhalation Sedation for Dental Extractions in Children. a Randomized, Cross-over, Clinical Trial. Acta Anaesthesiol Scand. 2007;51(8):1062-7. PubMed PMID: 17697301.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of transmucosal midazolam with inhalation sedation for dental extractions in children. A randomized, cross-over, clinical trial. AU - Wilson,K E, AU - Welbury,R R, AU - Girdler,N M, PY - 2007/8/19/pubmed PY - 2007/10/30/medline PY - 2007/8/19/entrez SP - 1062 EP - 7 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 51 IS - 8 N2 - BACKGROUND: The transmucosal route for conscious sedation in children has been reported widely in the field of medicine, but less so in dental patients. The aim of this study was to evaluate the efficacy and safety profile of midazolam (0.2 mg/kg) administered by the buccal transmucosal route, in comparison with nitrous oxide/oxygen inhalation sedation, for orthodontic extractions in 10-16-year-old dental patients. METHODS: Each patient attended for two visits and was randomly allocated to receive buccal midazolam (0.2 mg/kg) or nitrous oxide/oxygen titrated to 30%/70% at the first visit, the alternative being used at the second visit. The patients' vital signs, sedation levels and behavioural scores were recorded throughout. Post-operatively, side-effects, recall of the visit and satisfaction levels were recorded via questionnaire. RESULTS: Thirty-six patients, with a mean age of 12.9 years, completed both arms of the trial. The maximum level of sedation was achieved with buccal midazolam in a mean time of 14.42 min, compared with 7.05 min with inhalation sedation. The vital signs with both types of sedation remained within acceptable limits and the reported side-effects were of no clinical significance. Buccal midazolam was found to be acceptable by 65.7%. Only 28.6% of cases preferred this technique, the main disadvantage being the taste of the solution. CONCLUSION: Buccal midazolam sedation (0.2 mg/kg) seems to be equally as safe and effective as nitrous oxide/oxygen for the extraction of premolar teeth in anxious children. However, further research is required to refine the midazolam vehicle to improve acceptability. SN - 0001-5172 UR - https://www.unboundmedicine.com/medline/citation/17697301/Comparison_of_transmucosal_midazolam_with_inhalation_sedation_for_dental_extractions_in_children__A_randomized_cross_over_clinical_trial_ L2 - https://doi.org/10.1111/j.1399-6576.2007.01391.x DB - PRIME DP - Unbound Medicine ER -