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Special care dentistry: Midazolam conscious sedation for patients with neurological diseases
Pubblication date: /1/2010
Authors: P.L. Capp*, M.E.J. de Faria*, S.R.D.T. Siqueira**, M.T.P. Cillo***, E.G.B. Prado****, J.T.T. de Siqueira*****
Institution: Hospital das Clinicas, Medical School, University of Sao Paulo, Brazil
* Dentistry Division
** Assistant Professor, School of Arts, Science and Humanity
*** General anesthesia and sedation, Dentistry Division
**** Director of the Dentistry Division, Psychiatry Institute
***** Head of Orofacial Pain Team, Dentistry Division
Publication: European Journal of Paediatric Dentistry
Publisher: Ariesdue Srl
Keywords: Conscious sedation; Dental treatment; Midazolam; Special care; Special need.
Title: Special care dentistry: Midazolam conscious sedation for patients with neurological diseases
Abstract: Aim Midazolam is used very often to control the anxiety of patients for dental treatment, especially in patients with special needs. The objective of this study was to evaluate the efficiency of Midazolam in patients with neurological diseases referred for dental treatment.
Study design Descriptive study
Methods Forty consecutive patients with neurological disorders (encephalopathy, autism, and epilepsy) were referred to dental treatment, and 45 sedations were performed; all were sedated with Midazolam (intramuscular 0.2-0.3 mg/kg or intravenous 0.1mg/kg) and all were anesthetised with lidocaine 2% (0.5-2 mL). During the dental procedure, their behavior was analysed and classified into 3 categories: A (indifferent), B (reacted but allowed treatment), and C (did not allow treatment). Data were tabbed and statistically analysed.
Results The final patientsí classification was: A 22 (49%), B 18 (40%) and C 5 (11%); the patients with encephalopathy had the best results of sedation according to the proposed classification (p<0.05).
Conclusion Midazolam demonstrated to be effective in 89% of this sample for dental procedures in patients with neurological and behavioral disturbances, but it was less effective for patients with autism (p<0.05).