Evaluation of the Efficacy of Nasal Sedation Midazolam Compared with Dexmedetomidine in the Management of Uncooperative Children with Down Syndrome during Dental Treatment

Hamod, Mohamad Nabil; Kouchaji, Chaza; Rostom, Faten; Alzoubi, Hasan; Katbeh, Imad; Tuturov, Nikolay

doi:10.1155/2022/7344928

Cited by 2 publications

(2 citation statements)

References 14 publications

(15 reference statements)

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“…Some authors suggest that this might be a result of the decrease of the upper airway tone. Nonetheless, limited research suggests that midazolam premedication was not associated with higher incidence of complications in children with obstructive sleep apnea or Down syndrome [53][54][55] .…”

Section: Efficacymentioning

confidence: 99%

Pharmacological strategies to reduce perioperative anxiety in children – a narrative review

Knaeps,

Van de Putte,

Van de Velde

2023

Acta Anaest Belg

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Preoperative anxiety is common among children, resulting in negative postoperative behavior and increased postoperative pain. This review focuses on the practical use, safety, and efficacy of pharmacological strategies to reduce perioperative anxiety in children. The PubMed® database was searched using MeSH terms: ((care, preoperative) AND (children) AND (anti-anxiety drugs); (medication, preanesthetic) AND (child, preschool). An in-dept assessment was performed after which 85 articles were retrieved. Benzodiazepines (midazolam, diazepam), zolpidem, melatonin, opioids (fentanyl, butorphanol), alpha-2-adrenergic receptor agonists (clonidine, dexmedetomidine), ketamine and antihistamines (hydroxyzine, promethazine) were reviewed. Their pharmacological properties, routes of administration, doses, efficacy and (dis)advantages are discussed in this review. Based upon the results of our review, some suggestions can be made. Oral midazolam, oral clonidine, intranasally dexmedetomidine and the combination of oral ketamine and midazolam are recommendable products. Some other products like oral diazepam, butorphanol, ketamine intranasal s-ketamine + midazolam and hydroxyzine can be considered because of their proper safety profile and benefits. Further research should focus on patient selection for specific pharmacological and non-pharmacological interventions to achieve a tailored approach. Standardized assessment of anxiety, clinical significancy and feasibility should be included in the objectives of these studies.

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Section: Efficacymentioning

confidence: 99%

Pharmacological strategies to reduce perioperative anxiety in children – a narrative review

Knaeps,

Van de Putte,

Van de Velde

2023

Acta Anaest Belg

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“…Source:[15] (This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. )…”

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confidence: 99%

Rectal Sedation With Ketamine and Midazolam in the Management of Uncooperative Children During Dental Treatment: A Case Series and Method Description

Alzoubi,

Kabbani,

Taleb

et al. 2024

Cureus

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Background In pediatric dentistry, sedation aims to eliminate anxiety to facilitate the completion of dental procedures. Sedation in children is a multidimensional field that includes the child, parents/guardians, and the health care team. The rectal route is generally painless, making it suitable for children who are afraid of needles. This route has several advantages over the oral route, including reduced patient cooperation requirements, a faster and more predictable onset, and less physical trauma than the intravenous and intramuscular routes. This case series aimed to evaluate the effectiveness and success rate of rectal sedation with ketamine and midazolam in the management of uncooperative children during dental treatment. Case presentation Ten healthy children with definitely negative behavior were enrolled in this study. Each child was given 7 mg/kg of ketamine in combination with midazolam 0.1 mg/kg by the rectal route. The mean onset sedation time was 9.5 minutes, and pulpotomy procedures were done. Behavioral response was monitored throughout treatment using the Ohio State University Behavioral Rating Scale (OSUBRS), and the depth of sedation was measured using the University of Michigan Sedation Scale (UMSS). The Houpt General Behavior Scale was used to estimate the treatment success rate based on the overall behavior rating. All 10 cases showed good anxiolysis and cooperation following rectal administration, with no side effects observed. Conclusions Rectal administration of ketamine in combination with midazolam may be considered a reliable method in the management of uncooperative children during dental treatment. No adverse effects were observed during or after the sedation procedure.

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Evaluation of the Efficacy of Nasal Sedation Midazolam Compared with Dexmedetomidine in the Management of Uncooperative Children with Down Syndrome during Dental Treatment

Cited by 2 publications

References 14 publications

Pharmacological strategies to reduce perioperative anxiety in children – a narrative review

Pharmacological strategies to reduce perioperative anxiety in children – a narrative review

Rectal Sedation With Ketamine and Midazolam in the Management of Uncooperative Children During Dental Treatment: A Case Series and Method Description

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