BackgroundDental anxiety is prevalent in children. This condition may cause uncooperative behavior and need a treatment under general anesthesia. The perioperative period, especially for children, is a stressing event. Premedication is commonly used to reduce perioperative anxiety and facilitate the induction of anesthesia.Methods132 children candidates for dental treatment under GA were enrolled in this study and randomly divided into 3 groups. Oral melatonin, midazolam, and normal saline were administered as premedication. Patient’s sedation score before GA, the ease of intravenous line establishment, patient’s need for painkillers, and duration of recovery were evaluated and compared.ResultsRegarding the sedation score and response to IV access establishment, comparisons showed statistically significant differences between melatonin and midazolam groups (P < 0.05) as well as between midazolam and placebo groups (P < 0.001). The difference between melatonin and placebo groups was not significant (P > 0.05). The need for painkiller administration was statistically different between midazolam and placebo, melatonin and placebo, and midazolam and melatonin groups (P < 0.05). A statistically significant difference was also found between melatonin and midazolam as well as between melatonin and placebo groups (P < 0.05) with regard to the recovery duration while no significant difference was observed between midazolam and placebo groups (P > 0.05).ConclusionMidazolam is superior to melatonin for premedication regarding the patients’ sedation score before anesthesia and the ease of IV access establishment. Premedication with midazolam decreases the need for painkillers and increases the rate of recovery in children undergoing GA for dental treatment.
Background: Several methods including vibration have been proposed for pain control during a local anaesthetic injection. This study was aimed to evaluate the scientific evidence on vibration devices used to reduce injection pain perception in children. Methods: The search terms were chosen according to the Medical Subject Headings MeSH and non-MeSH. Potentially eligible studies involved the subjective or objective pain evaluation in children receiving any type of dental injection. An electronic search of published studies in English language was carried out in March 2020 on Scopus, Cochrane, and PubMed databases.Of 1659 articles retrieved initially, 14 were eligible to be included in the systematic review, of which eight articles were excluded. The vibration devices used in the studies included Buzzy or DentalVibe. Four studies using Dentalvibe contributed to the meta-analysis. Results: The results of meta-analysis indicated a mean difference of 0.057 for FLACC pain scores between intervention and control conditions (P-value = 0.740). Wong-Baker Faces scores showed a mean difference of 0.009 (Pvalue = 0.964), which also showed no statistically significant difference between the intervention and control groups. Conclusions: The findings revealed that use of DentalVibe for Paediatric dental injections was not effective in reducing pain perception. However, use of Buzzy showed promising results.
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