Kapur Aditi, Chawla H S, Gauba K, Goyal A, Bhardwaj N
Department of Pediatric Dentistry, Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Anesthesia, Sukhiqbal Dental Centre, Chandigarh, India.
Contemp Clin Dent. 2014 Jul;5(3):334-9. doi: 10.4103/0976-237X.137933.
A double-blind randomized control trial was conducted to assess the effect of oral-transmucosal midazolam sedation on changes in anxiety levels of precooperative children during a Class II amalgam restorative procedure.
A sample of 40 healthy, American Society of Anesthesiologists I, children aged 3-4 years having at least one carious primary mandibular molar requiring a Class II amalgam restoration with no previous dental history were randomly divided into experimental and control groups comprising of 20 children each. The children in the experimental group (Group I) received 0.5 mg/kg body weight of midazolam mixed in strawberry syrup and those in the control group (Group II) received the same syrup mixed in saline, 15 min prior to the restorative procedure. Routine nonpharmacological behavior management techniques were used in both groups. The anxiety levels were recorded using Venham's anxiety scale at the start and end of each procedural step.
There was a significant (P < 0.001) reduction in the anxiety levels of children in the experimental group on entry into the operatory compared with the control group. Introduction of each fear evoking stimuli showed a somewhat similar increase in anxiety levels in the two groups. In spite of a similar trend, the anxiety levels remained much lower in Group I than in Group II.
Midazolam in conjunction with behavior management is more helpful in relaxing the child initially than behavior management alone, thus increasing the chances of successful and easy accomplishment of further treatment steps.
进行一项双盲随机对照试验，以评估口腔黏膜咪达唑仑镇静对合作前儿童在Ⅱ类银汞合金修复手术过程中焦虑水平变化的影响。
选取40名健康的、美国麻醉医师协会分级为I级、年龄在3 - 4岁、至少有一颗需要进行Ⅱ类银汞合金修复且无既往牙科病史的龋齿下颌乳磨牙的儿童，随机分为实验组和对照组，每组20名儿童。实验组（I组）儿童在修复手术前15分钟接受0.5mg/kg体重的咪达唑仑与草莓糖浆混合液，对照组（II组）儿童接受相同糖浆与生理盐水混合液。两组均采用常规非药物行为管理技术。在每个手术步骤开始和结束时，使用韦纳姆焦虑量表记录焦虑水平。
与对照组相比，实验组儿童进入手术室时焦虑水平显著降低（P < 0.001）。引入每种引发恐惧的刺激后，两组焦虑水平的升高趋势相似。尽管趋势相似，但I组的焦虑水平仍远低于II组。
咪达唑仑联合行为管理在最初放松儿童方面比单独的行为管理更有帮助，从而增加了成功且顺利完成后续治疗步骤的机会。
