Department of Oral and Maxilla Facial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey.
Eur J Anaesthesiol. 2010 Apr;27(4):336-40. doi: 10.1097/EJA.0b013e32833111b2.
Midazolam is one of the most frequently used agents for sedation in paediatric dentistry. It is unclear how temperament traits and behaviour problems are related to sedation failure in children. We investigated whether sedation failure after premedication with oral midazolam can be predicted by behaviour problems and temperament traits.
Sixty children (aged 4-8 years) referred for dental treatment under sedation (40/60% N2O/O2), who had a Frankl Behaviour Scale score of at least 3, were premedicated with oral midazolam (0.75 mg kg(-1)). The level of sedation was assessed at defined time intervals, according to the Houpt Sedation Rating Scale. Children's sedation success during dental treatment was classified as satisfactory or unsatisfactory. Heart rate and oxygen saturation were evaluated by an oxygen saturation monitor in the sedation period. On the treatment day, parents completed 'The Revised Conners' Parent Rating Scale' and 'Short Temperament Scale for Children' to assess their child's behaviour problems and temperament, respectively.
The rates of sedation success were found to be satisfactory in 78.4% and unsatisfactory in 21.6%. Student's t-test demonstrated that in addition to the Short Temperament Scale for Children Inflexibility subscale being significant the Revised Conners' Parent Rating Scale: Long Form Psychosomatic subscale was also found to be a significant predictor of sedation failure.
Psychosomatic behaviour problems and an inflexible temperament trait might contribute to sedation failure in children undergoing dental treatment under midazolam premedication and N2O/O2 sedation. Appropriate patient selection based on the evaluation of childhood behavioural problems and temperament characteristics might increase midazolam sedation success in children.
咪达唑仑是小儿牙科镇静中最常用的药物之一。目前尚不清楚气质特征和行为问题与儿童镇静失败之间的关系。我们研究了在口服咪达唑仑预给药后，行为问题和气质特征是否可以预测镇静失败。
60 名（年龄 4-8 岁）因牙科治疗需要接受镇静（40/60% N2O/O2）的儿童，他们的 Frankl 行为量表评分为至少 3 分，口服咪达唑仑（0.75mg/kg）预给药。根据 Houpt 镇静评分量表，在规定的时间间隔评估镇静水平。将儿童在牙科治疗期间的镇静成功率分为满意或不满意。在镇静期间，通过血氧饱和度监测仪评估心率和血氧饱和度。在治疗当天，父母完成“修订版康纳斯父母评定量表”和“儿童短气质量表”，以分别评估他们孩子的行为问题和气质。
发现镇静成功率为 78.4%满意，21.6%不满意。学生 t 检验表明，除了儿童短气质量表的不灵活性亚量表显著外，修订版康纳斯父母评定量表：长形式躯体症状亚量表也被发现是镇静失败的显著预测因子。
在接受咪达唑仑预给药和 N2O/O2 镇静的儿童中，躯体行为问题和不灵活的气质特征可能导致镇静失败。根据儿童行为问题和气质特征的评估进行适当的患者选择，可能会增加儿童咪达唑仑镇静的成功率。
