Characteristics of Intravenous Midazolam Sedation with Nitrous Oxide in Pediatric Dental Treatment
10.5933/JKAPD.2020.47.1.53
- Author:
Hyuntae KIM
1
;
Ji-Soo SONG
;
Hong-Keun HYUN
;
Young-Jae KIM
;
Jung-Wook KIM
;
Ki-Taeg JANG
;
Sang-Hoon LEE
;
Teo Jeon SHIN
Author Information
1. Department of Pediatric Dentistry, School of Dentistry, Seoul National University
- Publication Type:1
- From:
Journal of Korean Academy of Pediatric Dentistry
2020;47(1):53-61
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Midazolam is a short-acting benzodiazepine that is widely used in pediatric dental sedation. However, its clinical effectiveness as an intravenous sedative agent in children has not been widely documented. A retrospective study was conducted to evaluate the efficacy and safety of intravenous midazolam and nitrous oxide inhalation sedation in pediatric dental treatment.
The subjects were 115 patients (118 cases) who received dental treatment under intravenous midazolam and nitrous oxide inhalation sedation. Demographic factors, general health status, sedation time, midazolam and nitrous oxide dosage, and success rate of sedation were evaluated from electronic medical records.
Behavioral management was the main reason of choosing sedation. Mean duration of sedation was 56.7 minutes for surgical treatment, and 74.4 minutes for restorative treatment. The initial dosage of intravenous midazolam was 0.051 ± 0.019 mg/kg. In 34 cases (28.8%), additional midazolam of 0.036 ± 0.057 mg/kg was delivered during the treatment. The concentration of nitrous oxide was maintained between 40% and 50%. The success rate of sedation was 99% (n = 117). In 1 case, laryngospasm occurred and the patient was reversed with benzodiazepine antagonist, flumazenil.
Intravenous midazolam sedation with nitrous oxide was shown to be clinically effective for the dental treatment in children, if administered by trained personnel and patients are carefully selected in accordance with guidelines.
