CLINICAL STUDY ON THE CONSCIOUS SEDATION WITH MIDAZOLAM INTRANASAL SPRAY

미다졸람의 비강내 분무를 이용한 의식진정에 대한 증례보고

The treatment for pediatric dental patient has become more complex than the previous, because patients of pediatric dentistry, younger than the previous, and they were often combined with systemic disease. And, the importnace of conscious sedation has been increased by this time for this reason. In a variety of CNS depressants, newly developed imidazobenzodiazepine (midazolam) is well known as a safe and effective medicament. It has a rapid onset, minimized cardiovascular depression and various possible administering, route, so it is commonly used for the conscious sedation of pediatric dental patients. Recently, "intranasal drop-in method" draws attention for its safety, but discomfort during administration and posterior dripping through pharynx diminish its popularity. Now more advanced method for intranasal administration is introduced for conscious sedation for pediatric dental patients, it is "intranasal spray" with aerosol form of medicament. With this method, we can achieve some benefits as belows : 1. Diminished discomfort during intranasal spray than nitranasal drop-in. 2. Rapid osnet and reduction than intranasal drop-in. 3. Eliminatin of adverse reaction, such as rhinorrhea. 4. More improved behavior rating scale.

Midazolam의 비강내 분무를 이용한 소아치과 환자의 의식진정하 치과치료 결과, 아래와 같은 특징들이 발견되었으며, 기존의 비강내 점적의 대표적인 단점인 posterior dripping이 대부분 제거되었음에도 불구하고, 상기도감염 등의 경우 보이는 비강내 충혈, 잦은 비루등의 경우에서는 이의 사용이 제한됨을 알 수 있었다. 1. 투여시 불편감의 감소 2. 점적의 경우보다 빠른 약효의 발현 및 회복 3. 점적시 보였던 rhinorrhea등 부작용의 감소 4. 점적시보다 개선된 행동양상의 표현