Comparison of oral midazolam with combination of oral midazolam and nitrous oxide inhalation in relation to safety of dental sedation in young children

Abstract

The objective of the study was to compare the safety of 0.6 mg/kg oral midazolam sedation alone with a combination of 0.6 mg/kg oral midazolam and nitrous oxide-oxygen sedation during dental treatment of young children. The study had a crossover design where every patient received two different sedation regimens i.e. oral midazolam 0.6 mg/kg alone and oral midazolam 0.6 mg/kg with nitrous oxide-oxygen inhalation during two dental treatment visits. Thirty children (17 males and 13 females) were selected for the study with mean age of 55.07 (+/- 9.29) months. Safety of the two regimens was evaluated by monitoring hemodynamic parameters (heart rate, blood pressure & oxygen saturation) and through observing the child for 24 hours post-sedation for any side effects such as nausea and vomiting. Very few changes in hemodynamics were noted from baseline during both the visits. However, the mean oxygen saturation level with oral midazolam and nitrous oxide-oxygen was significantly (p < 0.05) higher than oral midazolam alone. Postoperative side effects were very few and mainly remained limited to post-sedation drowsiness. It can be concluded that oral midazolam (0.6 mg/kg) alone and oral midazolam (0.6 mg/kg) plus nitrous oxide (30%-50%) sedation are both safe while providing dental treatment to children with behavior problems.