• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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• pp.772-781
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• 1998

The purpose of this study was to assess the sedative effect of intranasal spray with midazolam for management of the uncooperative 20 children aged from 24 months to 92 months who required extensive treatment. The patients were given randomly a dose of 0.2mg/kg of intranasal placebo, intranasal spray with midazolam, and intranasal drop with midazolam. All the children were restrained in a pediwrap and were monitored with pulse oximeter for assessing the pulse rate and peripheral oxygen saturation. According to Fukuta's behavior rating scale, behavior was checked for evaluation of the clinical sedative effect. The obtained results were as follows: 1. Behavior score of intranasal spray with midazolam was lower than intranasal drop with midazolam(P<0.01). 2. Pulse rate was a significant change as a function of dental procedure(P<0.001), however the peripheral oxygen saturation was not influenced significantly by either adiministration route of drug or dental procedure. Clinically, intranasal spray with midazolam were safe and effective sedation in young children undergoing pediatric dental procedures.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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• pp.782-787
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• 1998

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.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.283-291
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• 2000

The purpose of this study was to compare the sedative effect of three routes of administration - intramuscular, intranasal drop-in, intranasal spray - with midazolam. The twenty two uncooperative children from 23 months to 76 months who required at least three dental appointment. Each patient was assigned randomly to receive intramuscular(Group I, 0.15mg/kg), intranasal drop-in(Group II, 0.20mg/kg), intranasal spray(Group III, 0.20mg/kg) administration at each visit. Sleep, crying, movement, and overall behavior response were evaluated, and the sedative effects were evaluated by Houpt's rating scale In order to monitor the sedated patients, pulse rate and peripheral oxygen saturation were measured by pulse oximeter during treatment procedures. The results were as follows 1. Pulse rate and peripheral oxygen saturation were stable through all the treatment procedures, and there were no statistically significant differences among three routes of administration(P>0.05). 2. The effect on sleep was, III, II, I, in order, III group was the most effective through all the treatment procedures, except rubber-dam placement and filling phase (P<0.0001). 3. The effects on crying, movement, overall behavior were II, III, I, in order, II group was the most effective through all treatment procedures(P<0.0001).