scholarly journals Comparison of sedative effects of oral midazolam/chloral hydrate and midazolam/promethazine in pediatric dentistry

2018 ◽  
Vol 12 (3) ◽  
pp. 221-226 ◽  
Author(s):  
Majid Mehran ◽  
Ghassem Ansari ◽  
Mojtaba Vahid Golpayegani ◽  
Shahnaz Shayeghi ◽  
Leila Shafiei
Keyword(s):  
Chloral Hydrate ◽  
Dental Treatment ◽  
Vital Signs ◽  
Pediatric Dentistry ◽  
Double Blind ◽  
Treatment Standard ◽  
Group I ◽  
Oral Midazolam ◽  
Significant Difference ◽  
Sedative Effects

Background. The aim of this investigation was to compare the sedative effects of oral midazolam/chloral hydrate and midazolam/promethazine combinations on fearful children needing dental treatment. Methods. This crossover double-blind clinical trial was conducted on 30 children aged 2‒6 years, who had at least two similar teeth needing pulp treatment. Standard vital signs were recorded before and after premedication. Wilson sedation scale was used to judge the level of sedation. Cases were divided into two groups based on the sequence of medication received. This was to overcome the sequence effect. Group I received oral midazolam (0.4 mg/kg/chloral hydrate (50 mg/kg) at the first visit while they received midazolam (0.4 mg/kg)/promethazine (5 mg/kg) in their second visit. Group II received the premedication in the opposite sequence. The operator and child were blinded to the medication administered. Sedative efficacy of the two combinations were assessed and judged by two independent pediatric dentists based on the Wilson scale. Data were analyzed with ANOVA and paired t-test. Results. Only 10% of children who received chloral hydrate with midazolam exhibited high improvement in their behavior while 53% showed reasonable positive changes and 12% had no change or even deterioration of behavior. The difference between the effect of the two combination drugs was statistically significant (P<0.05) in favor of the chloral hydrate group. Conclusion. The results showed a significant difference in the sedation level induced between the two groups. Midazolam/chloral hydrate combination more effectively improved the co-operation for dental treatment.

scholarly journals A randomized, controlled, crossover trial of oral midazolam and hydroxyzine for pediatric dental sedation

2003 ◽  
Vol 17 (3) ◽  
pp. 206-211 ◽  
Author(s):  
Alessandra Rodrigues de Almeida Lima ◽  
Luciane Ribeiro de Rezende Sucasas da Costa ◽  
Paulo Sérgio Sucasas da Costa
Keyword(s):  
Dental Treatment ◽  
Statistical Tests ◽  
Vital Signs ◽  
Pediatric Dentistry ◽  
Double Blind ◽  
Randomized Controlled ◽  
Double Blind Clinical Trial ◽  
Oral Midazolam ◽  
And Behavior ◽  
Effective Sedation

The effectiveness of oral midazolam in pediatric dentistry is controversial. This randomized, controlled, crossover, double blind clinical trial was conducted in order to study the effect of midazolam, used either alone or in association with hydroxyzine, during child dental treatment. Thirty seven dental sedation sessions were carried out on 11 ASA I uncooperative children less than five years-old. In each appointment children were randomly assigned to groups: P - placebo, M - midazolam (1.0 mg/kg), or MH - midazolam (0.75 mg/kg) plus hydroxyzine (2.0 mg/kg). Vital signs (blood pressure, breathing rate, pulse and oxygen saturation) and behavior parameters (consciousness, crying, movement, overall behavior) were evaluated every 15 minutes. Friedman and Wilcoxon statistical tests were used to compare groups and different moments in the same group. Normal values of vital signs were usually registered. Heart rate increased in groups P and M as the session went on. Group M presented less crying and movement at the first 15 minutes of treatment. Group MH caused more drowsiness at the beginning of the session. Overall behavior was better in group M than in groups P or MH. Group M produced effective sedation in 77% of the cases, and group MH did so in 30.8%. It was concluded that midazolam was effective and safe, and its association with hydroxyzine did not lead to additional advantages in pediatric dental sedation.

Sedative effects of Oral Midazolam, Intravenous Midazolam and Oral Diazepam in the Dental Treatment of Children

2013 ◽  
Vol 37 (3) ◽  
pp. 301-306 ◽  
Author(s):  
P Tyagi ◽  
S Tyagi ◽  
A Jain
Keyword(s):  
Behavioral Changes ◽  
Positive Behavior ◽  
Negative Behavior ◽  
Group I ◽  
Oral Midazolam ◽  
Significant Difference ◽  
Sedative Effects ◽  
Group 3 ◽  
Group 2 ◽  
Oral Diazepam

Objective: To evaluate and compare the behavioral changes and effect of sedative techniques in pediatric dental patients using Oral Midazolam, Intravenous Midazolam and Oral Diazepam as sedative agents. Method: Triple blind randomized control trial with 40 patients aged between 2-10 years, exhibiting definitely negative behavior was considered. Patients were randomly assigned to one of the four treatment groups. Group I received midazolam 0.5mg/kg orally, Group II received 0.5mg/kg diazepam orally, Group III received 0.06mg/kg midazolam intravenously and Group IV received oral placebo. Behavioral changes (sleep, crying, movement, and overall behavior) and effect of sedative techniques on pediatric patients were assessed. Results: All the patients in group 3 were significantly better in post administrative behavior viz. sleep, crying and movement. Over all behavior scores for group 3 patients were significantly better than other three groups (p&lt;0.001). Positive behavior of patients in group 2 and 3 did not show significant difference but positive behavior in group 3 was significantly (p&lt;0.05) more than group 2. Placebo group showed the highest negative behavior. Conclusion: Sedative effects of oral midazolam and oral diazepam were comparable, where as intravenous midazolam produced more sedation. Anxiolysis was found to be more in both the midazolam groups than the diazepam group. Most number of positive changes were observed in midazolam groups as compared to diazepam group.

Sedative Effects of Oral Midazolam, Intravenous Midazolam and Oral Diazepam

2012 ◽  
Vol 36 (4) ◽  
pp. 383-388 ◽  
Author(s):  
P Tyagi ◽  
U Dixit ◽  
S Tyagi ◽  
A Jain
Keyword(s):  
Behavioral Changes ◽  
Positive Behavior ◽  
Negative Behavior ◽  
Group I ◽  
Oral Midazolam ◽  
Significant Difference ◽  
Sedative Effects ◽  
Group 3 ◽  
Group 2 ◽  
Oral Diazepam

To evaluate and compare the behavioral changes and effect of sedative techniques in pediatric dental patients using Oral Midazolam, Intravenous Midazolam and Oral Diazepam as sedative agents. Materials and Methods: Triple blind randomized control trial with 40 patients aged between 2-10 years, exhibiting definitely negative behavior was considered. Patients were randomly assigned to one of the four treatment groups. Group I received midazolam 0.5mg/kg orally, Group II received 0.5mg/kg diazepam orally, Group III received 0.06mg/kg midazolam intravenously and Group IV received oral placebo. Behavioral changes (sleep, crying, movement, and overall behavior) and effect of sedative techniques on pediatric patients were assessed. Results: All the patients in group 3 were significantly better in post administrative behavior viz. sleep, crying and movement. Over all behavior scores for group 3 patients were significantly better than other three groups (p&lt;0.001). Positive behavior of patients in group 2 and 3 did not show significant difference but positive behavior in group 3 was significantly (p&lt;0.05) more than group 2. Placebo group showed the highest negative behavior. Conclusion: Sedative effects of oral midazolam and oral diazepam were comparable, where as intravenous midazolam produced more sedation. Anxiolysis was found to be more in both the midazolam groups than the diazepam group. Most number of positive changes were observed in midazolam groups as compared to diazepam group.

Immersive and Non-Immersive Virtual Reality Distraction on Pain Perception to Intraoral Injections

2021 ◽  
Vol 45 (6) ◽  
pp. 389-394
Author(s):  
Supriya Kumari ◽  
Rachana Bahuguna ◽  
Nishita Garg ◽  
Ramakrishna Yeluri
Keyword(s):  
Virtual Reality ◽  
Pain Perception ◽  
Dental Treatment ◽  
Immersive Virtual Reality ◽  
Dental Procedures ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Chi Square Analysis

Objective: To evaluate the efficacy of immersive VR (IVR) and non-immersive VR (NIVR) distraction on perceived pain during intraoral injections in children undergoing dental procedures. The objective was to introduce 3-dimensional nature of virtual reality during the provoking phase of dental treatment as a means of distraction in children. Study design: A total of 200 children were selected for the study, 100 for IVR group and 100 for NIVR group. After randomization, children were introduced to Oculus Go Standalone equipment; MCDAS (f), VAS, WBFRS and the treatment procedure using tell show do technique. Group I children were introduced to oculus go standalone headset with hand held controller to play temple run or roller coaster game while in group II, children watched cartoon movies of their choice. Pre-operative & post-operative MCDAS scores were obtained using MCDAS (f) questionnaire in local language. Post-operatively, VAS and WBFRS scores were also obtained. The data was analyzed using independent t-test and chi-square analysis. Results: Pre-operatively, the mean MCDAS scores were similar in both the groups viz. Group–I (29.20 ± 3.197) and Group–II (29.09 ± 3.803) and is statistically not significant. Post-operatively, the mean MCDAS scores were higher in non-immersive group (20.72 ± 2.822) as compared to immersive group (10.99 ± 2.227). VAS score was higher in non-immersive group (2.72 ± 0.99) as compared to immersive group (0.75 ± 0.88). WBFRS scores were higher in non-immersive group (2.78 ± 1.097) as compared to immersive group (0.82 ± 1.104). Conclusion: Three-dimensional virtual reality was found to be an effective means of distraction in children undergoing dental procedures and especially during the provoking phase. The significant difference obtained clearly indicates irrespective of immersiveness of virtual reality, anxiety had been decreased and on comparison the pain perception to intraoral injection is less in immersive virtual reality environment. Immersive VR distraction technique can serve as an adjunct to traditional behavior management strategies already available to the pediatric dentist.

scholarly journals Evaluation of the Effects of 660-nm and 810-nm Low-Level Diode Lasers on the Treatment of Dentin Hypersensitivity

2020 ◽  
Vol 11 (2) ◽  
pp. 126-134
Author(s):  
Narges Naghsh ◽  
Mahdi Kachuie ◽  
Marzie Kachuie ◽  
Reza Birang
Keyword(s):  
Diode Laser ◽  
Repeated Measures ◽  
Diode Lasers ◽  
Tooth Surface ◽  
Control Group ◽  
Dentin Hypersensitivity ◽  
Double Blind ◽  
Group I ◽  
Significant Difference ◽  
Laser Group

Introduction: Dentin hypersensitivity is a common oral problem that occurs as a short and sharp pain. There are many techniques to treat this condition, the latest of which is laser treatment. The aim of this study was to evaluate the effect of two types of low-power diode lasers (660 nm and 810 nm) on dentin hypersensitivity in order to achieve an acceptable clinical application by adjusting the effective parameters. Methods: In this randomized, double-blind clinical trial, sensitive teeth of 7 patients were divided into three groups with a randomized matching method: group I, treated with 660-nm diode laser irradiation, group II, treated with diode laser 810-nm, and group III, the control group. Irradiation parameters for 660-nm and 810-nm diode lasers were the power of 30 mW and 100 mW respectively, in contact and continuous modes, perpendicular to the tooth surface with a sweeping motion. Treatments were carried out in four sessions at weekly intervals. The data obtained were analyzed with SPSS 22, using one-way repeated measures ANOVA and the LSD (least significant difference) test. The significance level was considered as P≤0.05. Results: There were no significant differences in visual analogue scale (VAS) score changes between the two laser groups after the intervention in the first, second and third weeks compared to the baseline (P>0.05). These changes in the fourth week were significantly higher in the 810-nm laser group compared to the 660-nm laser group (P=0.04), and in the 660-nm laser group, they were more than the control group (P=0.02). The mean VAS scores at 1-week, 1-month and 2-month postoperative intervals were significantly lower in the 810-nm laser group than in the 660-nm laser group, and in the 660-nm laser group, they were less than the control group (P<0.001). Conclusion: The use of 660-nm and 810-nm diode lasers with the power of 30 and 100 mW respectively for 120 seconds was effective in reducing pain in patients with dentin hypersensitivity. However, the effect of the 810-nm laser on reducing the dentin hypersensitivity was more long-lasting than that of the 660-nm laser.

Utility of Bispectral Index Monitoring during Deep Sedation in Pediatric Dental Patients

2014 ◽  
Vol 39 (1) ◽  
pp. 291-296 ◽  
Author(s):  
C Dag ◽  
T Bezgin ◽  
N Özalp ◽  
G Gölcüklü Aydın
Keyword(s):  
Dental Treatment ◽  
Deep Sedation ◽  
Pediatric Dentistry ◽  
P Value ◽  
Chi Square ◽  
Mean Values ◽  
Dental Patients ◽  
Physiological Variables ◽  
Paired Samples ◽  
Significant Difference

Objective: The aim of this study was to compare the total medicament doses and recovery profiles of patients for whom Bispectral Analysis (BIS) monitor was used to monitor sedation. Study design: Thirty-four uncooperative paediatric patients aged 3-6 years who attended to the Department of Pediatric Dentistry for dental treatment were enrolled in the study. Patients were randomly divided into 2 groups of 17 patients each. Physiological variables including oxygen saturation, blood pressure and heart rate were recorded. In one group (BIS-monitored group), drugs were administered to maintain patients’ BIS values between 60-70, while the other group (Non-BIS-monitored Group) was not monitored using BIS. Data was evaluated by Chi-square, Mann Whitney U, Independent Samples t, Paired Samples t and Wilcoxon signed tests, with a p-value of &lt;0.05 considered to be statistically significant. Results: There was no significant difference in total anesthetic doses, incidence of adverse events or recovery profiles of patients between non- BIS-monitored and BIS-monitored groups (p≯0.05). However, distinct correlation was determined among mean values of UMSS and BIS values (p&lt;0.05). Conclusion: BIS represents no advantage over the current commonly accepted methods for monitoring sedation depth in children.

scholarly journals Oral midazolam versus oral triclofos for sedation of children for computed tomography scan - a randomized clinical trial

2015 ◽  
Vol 2 (2) ◽  
pp. 41-45
Author(s):  
Anushu Gupta ◽  
Maitree Pandey ◽  
Lalita Choudhry ◽  
Aruna Jain ◽  
Harish Pemde
Keyword(s):  
Computed Tomography ◽  
Double Blind Study ◽  
Computed Tomography Scan ◽  
Double Blind ◽  
Comparable Rate ◽  
Group I ◽  
Oral Midazolam ◽  
Group Ii ◽  
Student’S T ◽  
Tomography Scan

Background: Effective and safe pediatric procedural sedation is still a concern especially in areas outside operation theatres. The aim of the study was to compare the efficacy and safety of oral triclofos and oral midazolam in children undergoing computed tomography.Methods: A prospective randomized double blind study was conducted in 100 children aged one to five years. Group-I (n=50) received oral triclofos 100 mg/kg and Group-II (n=50) oral midazolam 0.75 mg/kg. Both groups were given oral atropine 0.03 mg/kg and supplemented with intravenous midazolam upto 0.1 mg/kg in case of inadequate effect. Onset and duration of sedation, success for completion of procedure and time to recovery were noted. Student’s t test and Z test of proportions were used for statistical analysis.Results Majority of children 36(72%) in Group-I achieved Ramsay Sedation Score >4 as compared to 25(50%) in Group-II. Computed tomography scan could be successfully completed at comparable rate (52% vs 56%). Success rate improved to 96% vs 80% after supplementing intravenous midazolam in Group I & II respectively (p< 0.05). Onset (37.91minutes ± 7.96 vs 26 ± 10), duration of sedation ( 117.91minutes ± 72.41 vs 66.2minutes ± 33) were significantly shorter and recovery (98.19minutes ± 72.58 vs 47.4minutes ± 31.42) in Group I & II respectively was faster in children who received oral midazolam (p< 0.05).Conclusion We conclude that both drugs were equally effective and safe for computed tomography scan in children. However better recovery profile of midazolam makes it more suitable for day care procedures.Journal of Society of Anesthesiologists of Nepal 2015; 2(2): 41-45

scholarly journals Comparative Evaluation of Neem Mouthwash on Plaque and Gingivitis: A Double-blind Crossover Study

2017 ◽  
Vol 18 (7) ◽  
pp. 567-571 ◽  
Author(s):  
RS Dhanya ◽  
VJ Adarsh ◽  
Md Jalaluddin ◽  
UB Rajasekaran ◽  
CB Sudeep
Keyword(s):  
Crossover Study ◽  
Comparative Evaluation ◽  
Second Phase ◽  
Slight Reduction ◽  
Double Blind ◽  
Group I ◽  
Significant Difference ◽  
The Impact ◽  
Blind Crossover Study ◽  
Double Blind Crossover Study

ABSTRACT Aim The present study aimed at evaluating the impact of neemcontaining mouthwash on plaque and gingivitis. Materials and methods This randomized, double-blinded, crossover clinical trial included 40 participants aged 18 to 35 years with washout period of 1 week between the crossover phases. A total of 20 participants, each randomly allocated into groups I and II, wherein in the first phase, group I was provided with 0.2% chlorhexidine gluconate and group II with 2% neem mouthwash. After the scores were recorded, 1-week time period was given to the participants to carry over the effects of the mouthwashes and then the second phase of the test was performed. The participants were instructed to use the other mouthwash through the second test phase. Results There was a slight reduction of plaque level in the first phase as well as in the second phase. When comparison was made between the groups, no statistically significant difference was seen. Both the groups showed reduction in the gingival index (GI) scores in the first phase, and there was a statistically significant difference in both groups at baseline and after intervention (0.005 and 0.01 respectively). In the second phase, GI scores were reduced in both groups, but there was a statistically significant difference between the groups only at baseline scores (0.01). Conclusion In the present study, it has been concluded that neem mouthwash can be used as an alternative to chlorhexidine mouthwash based on the reduced scores in both the groups. Clinical significance Using neem mouthwash in maintaining oral hygiene might have a better impact in prevention as well as pervasiveness of oral diseases as it is cost-effective and easily available. How to cite this article Jalaluddin M, Rajasekaran UB, Paul S, Dhanya RS, Sudeep CB, Adarsh VJ. Comparative Evaluation of Neem Mouthwash on Plaque and Gingivitis: A Double-blind Crossover Study. J Contemp Dent Pract 2017;18(7):567-571.

Intra Operative Use of Anti Emetic Drugs for Children Undergoing Full Dental Rehabilitation under General Anesthesia. A Double Blind Randomized Clinical Trial

2016 ◽  
Vol 40 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Hisham Y El Batawi ◽  
Ahmed A Shorrab
Keyword(s):  
Clinical Trial ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Postoperative Nausea And Vomiting ◽  
Control Group ◽  
Double Blind ◽  
Dental Procedures ◽  
Dental Staff ◽  
Significant Difference ◽  
Dental Rehabilitation

Background: Postoperative Nausea and Vomiting (PONV) is a common complication following dental treatment under general anesthesia (DGA) that may lead to unplanned hospitalization, increased costs and dissatisfaction of parents. Aim: To investigate the incidence of Postoperative Vomiting (POV) on children who underwent dental rehabilitation under general anesthesia and to compare possible preventive effect of Dexamethasone and Ondansetron on occurrences of POV. Study design: A double blind randomized parallel clinical trial was carried out on 352 ASA I children who underwent DGA in a private Saudi hospital in Jeddah. Children were allocated randomly to four groups. Group D of 91 children, received Dexamethasone PONV prophylaxis, group O of 87 children received Ondansetron, group DO of 93 children received combination of the two drugs and group C the control group of 81 children. The three groups were investigated by blinded dental staff for POV episodes, number of times analgesia was needed and post anesthesia care unit time (PACUT). Results: There was a no significant difference between the two drugs on POV. There was a significant difference in POV between control group and groups D, O, and DO. There was significant reduction in need for analgesia in the Dexamethasone groups. The three groups, which had PONV prophylaxis, showed significant reduction in PACUT compared to control group. Conclusions: Antiemetic drugs are useful adjuncts in DGA. Some dental procedures may have higher emetic potential than others. The type of dental procedures done is to be considered when deciding the drug profile in children undergoing DGA.

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