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Sedation With a Combination of Dexmedetomidine and Midazolam for Pediatric Dental Surgery.

Abstract

Intravenous sedation (IVS) is commonly used to complete dental treatment for uncooperative pediatric patients. Propofol (PRO) is widely used for IVS because of its short context sensitive half-time and amnestic effect. However, administering PRO to patients who have a history of egg anaphylaxis is still somewhat controversial. The evidence that supports the potential risks for allergic reactions following PRO use in patients with egg allergies is limited with some anesthesiologists recommending against its use in these patients. Alternative drug regimens for procedural sedation in this population are therefore desirable. Dexmedetomidine (DEX), a selective α-2 agonist, has antianxiety and sedative properties and has been widely used not only for procedural sedation with mild inhibitory effects on respiration but also during minor surgeries for its analgesic effect. In this paper, we describe the successful administration of a combination of DEX and low-dose midazolam (MDZ) for sedation in an uncooperative pediatric patient. Both DEX and MDZ have been reported as safe and useful sedatives for dental treatment, and their combination may provide a helpful option for IVS of pediatric patients for whom PRO is not preferred.

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  • Authors+Show Affiliations

    ,

    Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University, Kokurakita, Kitakyushu, Japan.

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    Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University, Kokurakita, Kitakyushu, Japan.

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    Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University, Kokurakita, Kitakyushu, Japan.

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    Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University, Kokurakita, Kitakyushu, Japan.

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    Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University, Kokurakita, Kitakyushu, Japan.

    ,

    Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University, Kokurakita, Kitakyushu, Japan.

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    Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University, Kokurakita, Kitakyushu, Japan.

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    Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University, Kokurakita, Kitakyushu, Japan.

    ,

    Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University, Kokurakita, Kitakyushu, Japan.

    Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University, Kokurakita, Kitakyushu, Japan.

    Source

    Anesthesia progress 65:2 2018 pg 124-126

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    29952643

    Citation

    TY - JOUR T1 - Sedation With a Combination of Dexmedetomidine and Midazolam for Pediatric Dental Surgery. AU - Sago,Teppei, AU - Shiiba,Shunji, AU - Ando,Eika, AU - Kondo,Kiriko, AU - Tsunakake,Misato, AU - Akitomi,Sayaka, AU - Ono,Aya, AU - Kato,Yukari, AU - Chogyoji,Yuki, AU - Watanabe,Seiji, PY - 2018/6/29/entrez PY - 2018/6/29/pubmed PY - 2018/6/29/medline KW - Dental treatment KW - Dexmedetomidine KW - Midazolam KW - Pediatric sedation SP - 124 EP - 126 JF - Anesthesia progress JO - Anesth Prog VL - 65 IS - 2 N2 - Intravenous sedation (IVS) is commonly used to complete dental treatment for uncooperative pediatric patients. Propofol (PRO) is widely used for IVS because of its short context sensitive half-time and amnestic effect. However, administering PRO to patients who have a history of egg anaphylaxis is still somewhat controversial. The evidence that supports the potential risks for allergic reactions following PRO use in patients with egg allergies is limited with some anesthesiologists recommending against its use in these patients. Alternative drug regimens for procedural sedation in this population are therefore desirable. Dexmedetomidine (DEX), a selective α-2 agonist, has antianxiety and sedative properties and has been widely used not only for procedural sedation with mild inhibitory effects on respiration but also during minor surgeries for its analgesic effect. In this paper, we describe the successful administration of a combination of DEX and low-dose midazolam (MDZ) for sedation in an uncooperative pediatric patient. Both DEX and MDZ have been reported as safe and useful sedatives for dental treatment, and their combination may provide a helpful option for IVS of pediatric patients for whom PRO is not preferred. SN - 1878-7177 UR - https://www.unboundmedicine.com/medline/citation/29952643/Sedation_With_a_Combination_of_Dexmedetomidine_and_Midazolam_for_Pediatric_Dental_Surgery L2 - http://www.anesthesiaprogress.org/doi/10.2344/anpr-65-03-14?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed ER -