Orally administered Midazolam at dosages of 0.5, 0.6, and 0.75 mg/kg was used with 34 healthy, uncooperative pediatric dental patients. Effective pre-operative sedation occurred within approximately 15 minutes with a 30- to 40-minute duration of action. Blood pressure and respiration remained stable throughout. The numbers and types of procedures performed were dependent on the degree of sedation, the behavior of the patient, the experience of the operator, and the operator's ability to administer the medication. The ideal dosage appears to be 0.6 mg/kg, with an average change of 1.43 Frankel Units in behavior modification. A dosage of 0.5 mg/kg appears to yield erratic results, while a dosage of 0.75 mg/kg offers little advantage with greater potential for adverse reactions. The oral administration of Midazolam for pediatric patients with extreme behavioral problems, such as Attention Deficit Hyperactive Disorder, was of little advantage and may produce an idiosyncratic reaction. Midazolam's quick onset and short duration of action, coupled with its ideal properties of sedation, relaxation, and amnesia, offer a viable alternative for treating the anxious, uncooperative pediatric dental patient.
Two experiments were performed to evaluate characteristics of heart activity as discriminative stimuli. In Study I two multiple baseline across subjects designs were utilized to assess the efficacy of trial and error and fading procedures in increasing the detection of heart rate activity above and below an average level. Both trial and error and fading procedures were effective in increasing discrimination accuracy. A 4.4 bpm interval around the subject's mean heart rate was employed as the discriminative stimulus in Study II. Significant stimulus control exerted by the criterion stimuli was found during both training and testing conditions. Experimental procedures were discussed for determining which sensory events in a complex stimulus dimension such as a physiological change are actually exerting stimulus control.
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