Effectiveness and acceptability of intravenous sedation in child and adolescent dental patients: report of a case series at King's College Hospital, London

Conscious Sedation Procedures Using Intravenous Midazolam for Dental Care in Patients with Different Cognitive Profiles: A Prospective Study of Effectiveness and Safety

“…However, the technique showed good effectiveness and safety when the IV midazolam protocol was accepted and IV midazolam was even preferred to nitrous oxide most of the time. One recent study also reported very good or excellent behaviour during dental treatment under IV sedation for 83% of 365 patients aged 7 to 16 years [29]. In adults with learning disability and challenging behaviour, two consecutive audits have investigated the use of intravenous titration to the sedation endpoint after intranasal midazolam premedication to facilitate cannulation [30], [31].…”

Reported side effects of intravenous midazolam sedation when used in paediatric dentistry: a review

“…After combining results from MEDLINE and Embase searches and removing papers that did not meet the criteria, four papers were included. Two further non‐English papers were included after authors were contacted for further information.…”

“…Excessive body movement was therefore (14) 33 minor side effects reported in total (19.5%) Table 6. Summary of non-randomised studies [27][28][29][30]32,34 . Side effects of IV midazolam in paediatric dentistry Dose ranged from 1.5 to 10 mg 0 118 (17) 118 minor side effects reported in total (16.8%) *Where both patient numbers and number treatment episodes were given, treatment episodes were used in the calculation of the overall sum.…”

“…Venepuncture success will depend on the skills of the seditionist and cooperation of the child during cannulation. It was noted that only five studies described the use of a cutaneous topical anaesthetic such as EMLA cream or ethyl chloride spray prior to venous cannulation, an important step which is advised by SDCEP guidelines. Previous research has demonstrated the benefits of nitrous oxide as an adjunct for successful paediatric venous cannulation, revealing that nitrous oxide provides greater analgesia and anxiolysis than EMLA cream alone.…”

“…In six of the studies in this review, an anaesthetist acted as the sedationist 11,[23][24][25]29,34 , in three studies, the dentist was the sedationist 26,28,30 , and in two studies, this information was not recorded 27,32 . The authors agree that the sedationist should be appropriately trained in paediatric cannulation, IV sedation and, at the minimum, be trained in intermediate paediatric life support.…”