Primosch R E, Bender F
Department of Pediatric Dentistry, University of Florida, PO Box 100426, Gainesville, FL 32610-0426, USA.
ASDC J Dent Child. 2001 Jul-Aug;68(4):233-8, 228.
Midazolam conscious sedation records of pediatric dental patients, one to six years of age, were reviewed retrospectively to: 1) examine the factors associated with the use of oral and nasal routes of administration and their effect on displayed behavior during dental treatment and 2) determine whether a child's compliance with oral administration is predictive of the intraoperative behavior displayed during dental treatment. Two hundred and fifty-seven conscious sedation records for 222 pediatric dental patients sedated with orally or nasally administered midazolam for dental treatment at the University of Florida were reviewed. Data collected included the patient's age, gender, route of administration, dose, compliance with oral administration, appointment type (planned vs. emergency), previous sedation experience with midazolam, operator vs. parent administration of the medication, use of papoose board and nitrous oxide/oxygen inhalation, types of procedures performed (restorations only, extractions only, or both), length of treatment rendered, and preoperative and intraoperative behavioral assessments of the child. The collected data were analyzed with Statview software using ANOVA and Chi-square analyses. There was a statistically significant difference (p < 0.001) between oral and nasal administration for the parameters of age, procedure length, appointment type, procedures performed, previous sedation experience and use of the papoose board and nitrous oxide/oxygen inhalation. While there was no statistically significant influence of chronological age on the preoperative Frankl behavior ratings, there was a statistically significant mean age difference with respect to the administrator of the medication (parent vs. operator), papoose board use, N2O/O2 use and previous sedation experience. Forty-five percent of the subjects were willing to accept oral administration of the medication, however, there was no statistically significant difference (p = 0.114) between the child's compliance to accept the medication and the intraoperative Frankl behavioral ratings displayed during dental treatment. In this review of midazolam conscious sedation records of pediatric dental patients. 1) route of administration was significantly influenced by several patient and procedural variables, resulting in different behavioral outcomes and 2) compliance with oral administration was not predictive of behavior displayed during treatment.
对1至6岁儿童牙科患者的咪达唑仑清醒镇静记录进行回顾性研究，目的是：1）研究与口服和鼻内给药途径使用相关的因素及其对牙科治疗期间表现出的行为的影响；2）确定儿童对口服给药的依从性是否可预测牙科治疗期间的术中行为。回顾了佛罗里达大学222名接受口服或鼻内咪达唑仑镇静进行牙科治疗的儿童牙科患者的257份清醒镇静记录。收集的数据包括患者的年龄、性别、给药途径、剂量、对口服给药的依从性、预约类型（计划内 vs. 急诊）、既往咪达唑仑镇静经验、药物由操作者还是家长给药、是否使用约束板和一氧化二氮/氧气吸入、进行的手术类型（仅修复、仅拔牙或两者皆有）、治疗时长以及儿童术前和术中的行为评估。使用Statview软件对收集的数据进行方差分析和卡方分析。在年龄、手术时长、预约类型、进行的手术、既往镇静经验以及约束板和一氧化二氮/氧气吸入的使用等参数方面，口服和鼻内给药之间存在统计学显著差异（p < 0.001）。虽然实际年龄对术前弗兰克尔行为评分没有统计学显著影响，但在药物给药者（家长 vs. 操作者）、约束板使用、N2O/O2使用和既往镇静经验方面存在统计学显著的平均年龄差异。45%的受试者愿意接受口服给药，然而，儿童接受药物的依从性与牙科治疗期间显示的术中弗兰克尔行为评分之间没有统计学显著差异（p = 0.114）。在本次对儿童牙科患者咪达唑仑清醒镇静记录的回顾中，1）给药途径受几个患者和手术变量的显著影响，导致不同的行为结果；2）对口服给药的依从性不能预测治疗期间的行为表现。
