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Premedication with midazolam in intellectually disabled dental patients: intramuscular or oral administration? A retrospective study.

Hanamoto H, Boku A, Sugimura M, Oyamaguchi A, Inoue M, Niwa H - Med Oral Patol Oral Cir Bucal (2016)

Bottom Line: There were no differences in demographic data and other variables between the groups.The results of this study suggest that oral premedication with 0.3 mg/kg of midazolam is more effective than 0.15 mg/kg of midazolam administered intramuscularly, in terms of patient resistance to venous cannulation.If both oral and intramuscular routes of midazolam are acceptable in intellectually disabled patients, the oral route is recommended.

View Article: PubMed Central - PubMed

Affiliation: Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka, Japan, hanamoto@dent.osaka-u.ac.jp.

ABSTRACT

Background: The use of midazolam for dental care in patients with intellectual disability is poorly documented. The purpose of this study was to determine which method of premedication is more effective for these patients, 0.15 mg/kg of intramuscular midazolam or 0.3 mg/kg of oral midazolam.

Material and methods: This study was designed and implemented as a non-randomized retrospective study. The study population was composed of patients with intellectual disability who required dental treatment under ambulatory general anesthesia from August 2009 through April 2013. Patients were administered 0.15 mg/kg of midazolam intramuscularly (Group IM) or 0.3 mg/kg orally (Group PO). The predictor variable was the method of midazolam administration. The outcome variables measured were Observer's Assessment of Alertness/ Sedation (OAA/S) Scale scores, the level of cooperation when entering the operation room and for venous cannulation, post-anesthetic agitation and recovery time.

Results: Midazolam was administered intramuscularly in 23 patients and orally in 21 patients. More patients were successfully sedated with no resistance behavior during venous cannulation in Group PO than in Group IM (p=0.034). There were no differences in demographic data and other variables between the groups.

Conclusions: The results of this study suggest that oral premedication with 0.3 mg/kg of midazolam is more effective than 0.15 mg/kg of midazolam administered intramuscularly, in terms of patient resistance to venous cannulation. If both oral and intramuscular routes of midazolam are acceptable in intellectually disabled patients, the oral route is recommended.

No MeSH data available.


Related in: MedlinePlus

Flow diagram demonstrating patient inclusion in the study.
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Figure 1: Flow diagram demonstrating patient inclusion in the study.

Mentions: Anesthesia records of 159 patients were reviewed and a total of 44 patients were finally analyzed. Twenty-three patients were administered midazolam intramuscularly and 21 orally (Fig. 1). Table 1 presents the clinical characteristics and procedural summary of all patients. There were no significant differences in age, gender, height, body weight, medications such as tranquilizers and anticonvulsant drugs, anesthesia time, operation time and recovery time between the two groups. There were also no significant differences in the number of patients with and without mental retardation, autism, cerebral palsy and epilepsy.


Premedication with midazolam in intellectually disabled dental patients: intramuscular or oral administration? A retrospective study.

Hanamoto H, Boku A, Sugimura M, Oyamaguchi A, Inoue M, Niwa H - Med Oral Patol Oral Cir Bucal (2016)

Flow diagram demonstrating patient inclusion in the study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4920461&req=5

Figure 1: Flow diagram demonstrating patient inclusion in the study.
Mentions: Anesthesia records of 159 patients were reviewed and a total of 44 patients were finally analyzed. Twenty-three patients were administered midazolam intramuscularly and 21 orally (Fig. 1). Table 1 presents the clinical characteristics and procedural summary of all patients. There were no significant differences in age, gender, height, body weight, medications such as tranquilizers and anticonvulsant drugs, anesthesia time, operation time and recovery time between the two groups. There were also no significant differences in the number of patients with and without mental retardation, autism, cerebral palsy and epilepsy.

Bottom Line: There were no differences in demographic data and other variables between the groups.The results of this study suggest that oral premedication with 0.3 mg/kg of midazolam is more effective than 0.15 mg/kg of midazolam administered intramuscularly, in terms of patient resistance to venous cannulation.If both oral and intramuscular routes of midazolam are acceptable in intellectually disabled patients, the oral route is recommended.

View Article: PubMed Central - PubMed

Affiliation: Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka, Japan, hanamoto@dent.osaka-u.ac.jp.

ABSTRACT

Background: The use of midazolam for dental care in patients with intellectual disability is poorly documented. The purpose of this study was to determine which method of premedication is more effective for these patients, 0.15 mg/kg of intramuscular midazolam or 0.3 mg/kg of oral midazolam.

Material and methods: This study was designed and implemented as a non-randomized retrospective study. The study population was composed of patients with intellectual disability who required dental treatment under ambulatory general anesthesia from August 2009 through April 2013. Patients were administered 0.15 mg/kg of midazolam intramuscularly (Group IM) or 0.3 mg/kg orally (Group PO). The predictor variable was the method of midazolam administration. The outcome variables measured were Observer's Assessment of Alertness/ Sedation (OAA/S) Scale scores, the level of cooperation when entering the operation room and for venous cannulation, post-anesthetic agitation and recovery time.

Results: Midazolam was administered intramuscularly in 23 patients and orally in 21 patients. More patients were successfully sedated with no resistance behavior during venous cannulation in Group PO than in Group IM (p=0.034). There were no differences in demographic data and other variables between the groups.

Conclusions: The results of this study suggest that oral premedication with 0.3 mg/kg of midazolam is more effective than 0.15 mg/kg of midazolam administered intramuscularly, in terms of patient resistance to venous cannulation. If both oral and intramuscular routes of midazolam are acceptable in intellectually disabled patients, the oral route is recommended.

No MeSH data available.


Related in: MedlinePlus