Intranasal Midazolam Premedication for Anxiolysis in Children Prior to Nitrous Oxide Sedation | Chapter 1 | Achievements and Challenges of Medicine and Medical Science Vol. 12

Background: Children and adolescents show diverse maturity, personality, temperament, and emotions, which lead to a variety in their vulnerability and coping ability in dental situations. Therefore, dentists need a plethora of techniques to manage children. Midazolam, a benzodiazepine has enjoyed a lot of attention in recent years as a good pediatric sedative agent.

Aim: The aim of the study was to compare the administration of 0.1 mg/kg intranasal midazolam as premedication against a normal saline control in alleviating anxiety relating to and increasing acceptance of nasal hood by child patients receiving nitrous oxide sedation for dental treatment.

Materials and Methods: After ethical clearance and informed consent, on the basis of odd and even numbers patients were allocated to group midazolam or group normal saline, respectively. Thirty children between the ages of 4–8 years requiring bilateral endodontic treatment with Frankl’s negative or definitely negative behavior were selected. The physical parameters were recorded at the beginning and after the dental procedure; the time required for the procedure was also recorded. The level of cooperation during acceptance of the nasal mask by the patient was evaluated using the four-point scale. The sensory perception levels (alertness) and overall behavior of the child were evaluated using the first and fourth categories of the Houpt Behavior Rating scale.

Results: Participants in group N consumed more time than group M. A Higher percentage of children were seen in the time frame of 31 minutes and more in group N and group M timings were largely concentrated around the 30 minutes or less mark. Midazolam premedication was more effective in improving the acceptance of the nasal hood in children than without premedication (p=.002308).

Conclusion: In the present study, the combination of midazolam and nitrous oxide proved to be an effective combination, resulting in good to excellent behavior in children who were Frankl’s behavior rating definitely negative and negative. The operator could carry out the procedure at all stipulated 60 appointments, the combination of the two agents proved to be 100% safe there were no adverse reactions reported in both the groups and the physiologic markers were within limits.

Clinical Significance: For successful sedation premedication with nitrous oxide, midazolam is an excellent premedication drug.

 

Author (s) Details

 

Shikha Choubey
Department Pediatric and Preventive Dentistry, I.T.S. Dental College, Ghaziabad, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v12/3306

Determination of the Effectiveness of Oral Midazolam as a Pre-medication in Paediatric Patients: A Brief Overview | Chapter 7 | Research Developments in Medicine and Medical Science Vol. 1

 This phase aims to assess the productiveness and safety of oral midazolam to defeat the anxiety and upgrade behaviour in children withstanding general anaesthesia. The aim of premedication in the paediatric exclusive informal network is to produce temperance and anxiolysis, reduce passionate trauma and facilitate maternal separation besides quiet and smooth initiation of anaesthesia. In a double-blind randomised clinical trial, 90 toddlers aged 1 to 8 age were randomly filling a place one of three oral premedication groups. Each group had 30 kids. Group I received 0.5 mg/kg spoken midazolam, while Group II received 0.75 mg/kg spoken midazolam in a total volume of 5 ml of 25% dextrose.  A 5 ml measure of 25% dextrose was likely to Group III or the control group. We investigated the attack and depth of sedation, changes in signs of life like heart rate, ancestry pressure, and mental state before and later sedation, as well as some side effects that power have occurred subsequently the procedure. After premedication,1. The difference in signs of life, systolic blood pressure and signs of life between the three groups were not statistically meaningful2. Sedation at 30 minutes after premedication was better in students that study together II as compared to students that study together I3. The emotional state was concluded expected better in study Group II (0.75 mg/ kg) as distinguished to study group I (0.5 mg/kg) concurrently with an activity of separation from parents.4. More post-functioning complications like sickness in stomach, vomiting, dizziness, and headache were seen accompanying a dose of 0.75 mg/kg than accompanying a dose of 0.5 mg/kg.It is decided that premedication with oral midazolam at a dosage of 0.5 mg/kg in paediatric patients results in good to superior sedation inside 30 minutes of separation from persons, with better quality of break-up. Additionally, it offers a steady emotional state during the whole of induction, accompanying less postoperative problems and little hemodynamic alterations.

Author(s) Details:

Jayashree Phaltankar,
Department of Anaesthesia, Maharashtra Postgraduate Institute of Medical Education and Research, Nashik, India.

Milin Shah,
Department of Anaesthesia, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India.

Please see the link here: https://stm.bookpi.org/RDMMS-V1/article/view/9624