Oral sedation for dental treatment in young children in a hospital setting.

INTRODUCTION

Conscious sedation for young children is a rapidly developing area of clinical activity. Many studies have shown positive results using oral midazolam on children. These case series investigated oral midazolam conscious sedation as an alternative to general anaesthesia in a clinical service setting.

OBJECTIVE

The purpose of this work was to determine the safety and efficacy of oral midazolam for conscious sedation in children undergoing dental treatment.

METHODS

Patients were selected by colleagues for treatment under oral sedation. The main general criteria were weight below 36 kilos and ASA I, II, or III. Midazolam 0.5 mg/kg was administered orally. A pulse oximeter was applied to a finger to monitor vital signs and the Houpt scale was used to assess behaviour.

RESULTS

A total of 510 children aged between 13 months and 11 years were included. The behaviour of 379 (74%) was excellent or very good. The pulse rate and peripheral oxygenation were within the normal range for all patients. The main adverse effects were diplopia and post-sedation dysphoria.

CONCLUSIONS

Oral midazolam is a safe and effective method of sedation although some children were agitated and distressed either during or after treatment. Parents need to be warned about this.