Resident: Cho
Date: 2/22/2012
Author(s): Kil et al.
Journal: Pediatric Dentistry 25:2, 2003
Type of Journal: Scientific Article
Purpose: Evaluate the effectiveness of a standard dose of midazolam in asthmatic patients undergoing dental treatment.
Methods:
24 children aged between 19 to 65 months with mild to moderate asthma needing dental treatment with sedation were enrolled in the study. The severity of the asthma was based on consultation with the parents and/or the child’s physician.
Of the 24 patients, 21 had mild-intermittent or mild-persistent asthma, while the remaining 3 had a diagnosis of moderate-persistent asthma. The day of sedation children were NPO 4 hours prior. Oxygen saturation, pulse rate, and respiratory rate were measured pre-op, during, and post-op. Each child was given 0.5mg/kg of midazolam orally. At the end, asthma score were determined again.
Key points in the article discussion:
23 of the 24 subjects had an asthma score of 0. 1 subject had asthma score of 1 had a diagnosis of moderate-persistent asthma with daily use of albuterol. This patient had wheezing present before and after treatment, however, oxygen saturation was always above 95%.
Oxygen saturation was consistently above 95% except for two patients during treatment had oxygen saturation fall down to 94%. However, when the head and neck were repositioned, oxygen saturation increased. After treatment, all patients had the same asthma score as their initial score. Respiratory rates remained consistent. Pulse rate increased based on stimulation. 12 subjects had excellent behavior, 5 subjects had satisfactory behavior, and 7 subjects had unsatisfactory behavior.
Sedation with 0.5mg/kg of midazolam when given orally produces little to no adverse effects on asthmatic patients presenting with mild to moderate symptoms.
Assessment of the article: Good article. Would be interested to see a similar study with the addition of hydroxyzine to the midazolam.
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