Conscious sedation procedures using intravenous midazolam for dental care in patients with different cognitive profiles: a prospective study of effectiveness and safety
The use of midazolam for dental care in patients with intellectual disability is poorly documented. This study aimed to evaluate the effectiveness and safety of conscious sedation procedures using intravenous midazolam in adults and children with intellectual disability (ID) compared to dentally anx...
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| description | The use of midazolam for dental care in patients with intellectual disability is poorly documented. This study aimed to evaluate the effectiveness and safety of conscious sedation procedures using intravenous midazolam in adults and children with intellectual disability (ID) compared to dentally anxious patients (DA). Ninety-eight patients with ID and 44 patients with DA programmed for intravenous midazolam participated in the study over 187 and 133 sessions, respectively. Evaluation criteria were success of dental treatment, cooperation level (modified Venham scale), and occurrence of adverse effects. The mean intravenous dose administered was 8.8±4.9 mg and 9.8±4.1 mg in ID and DA sessions respectively (t-test, NS). 50% N₂O/O₂ was administered during cannulation in 51% of ID sessions and 61% of DA sessions (NS, Fisher exact test). Oral or rectal midazolam premedication was administered for cannulation in 31% of ID sessions and 3% of DA sessions (p |
| doi_str_mv | 10.1371/journal.pone.0071240 |
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This study aimed to evaluate the effectiveness and safety of conscious sedation procedures using intravenous midazolam in adults and children with intellectual disability (ID) compared to dentally anxious patients (DA). Ninety-eight patients with ID and 44 patients with DA programmed for intravenous midazolam participated in the study over 187 and 133 sessions, respectively. Evaluation criteria were success of dental treatment, cooperation level (modified Venham scale), and occurrence of adverse effects. The mean intravenous dose administered was 8.8±4.9 mg and 9.8±4.1 mg in ID and DA sessions respectively (t-test, NS). 50% N₂O/O₂ was administered during cannulation in 51% of ID sessions and 61% of DA sessions (NS, Fisher exact test). Oral or rectal midazolam premedication was administered for cannulation in 31% of ID sessions and 3% of DA sessions (p<0,001, Fisher exact test). Dental treatment was successful in 9 out of 10 sessions for both groups. Minor adverse effects occurred in 16.6% and 6.8% of ID and DA sessions respectively (p = 0.01, Fisher exact test). Patients with ID were more often very disturbed during cannulation (25.4% ID vs. 3.9% DA sessions) and were less often relaxed after induction (58.9% ID vs. 90.3% DA) and during dental treatment (39.5% ID vs. 59.7% DA) (p<0.001, Fisher exact test) than patients with DA. When midazolam sedation was repeated, cooperation improved for both groups. Conscious sedation procedures using intravenous midazolam, with or without premedication and/or inhalation sedation (50% N₂O/O₂), were shown to be safe and effective in patients with intellectual disability when administered by dentists.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0071240</identifier><identifier>PMID: 23940729</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Adults ; Aged ; Anesthesia ; Anesthesia, Dental - adverse effects ; Anesthesia, Dental - methods ; Anesthetics, Intravenous - administration & dosage ; Anxiety ; Anxiety Disorders - epidemiology ; Cannulation ; Child ; Children ; Cognition - physiology ; Cognitive ability ; Comparative analysis ; Conscious Sedation - adverse effects ; Conscious Sedation - methods ; Cooperation ; Dental Care ; Dental insurance ; Dentistry ; Drugs ; Female ; Humans ; Inhalation ; Intellectual disabilities ; Intellectual Disability - epidemiology ; Intravenous administration ; Learning disabilities ; Male ; Medical research ; Medicine ; Midazolam ; Midazolam - administration & dosage ; Middle Aged ; Nitrous oxide ; Patients ; Rectum ; Respiration ; Safety ; Safety and security measures ; Side effects ; Studies ; Surgery ; Treatment Outcome ; Young Adult</subject><ispartof>PloS one, 2013-08, Vol.8 (8), p.e71240-e71240</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Collado et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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This study aimed to evaluate the effectiveness and safety of conscious sedation procedures using intravenous midazolam in adults and children with intellectual disability (ID) compared to dentally anxious patients (DA). Ninety-eight patients with ID and 44 patients with DA programmed for intravenous midazolam participated in the study over 187 and 133 sessions, respectively. Evaluation criteria were success of dental treatment, cooperation level (modified Venham scale), and occurrence of adverse effects. The mean intravenous dose administered was 8.8±4.9 mg and 9.8±4.1 mg in ID and DA sessions respectively (t-test, NS). 50% N₂O/O₂ was administered during cannulation in 51% of ID sessions and 61% of DA sessions (NS, Fisher exact test). Oral or rectal midazolam premedication was administered for cannulation in 31% of ID sessions and 3% of DA sessions (p<0,001, Fisher exact test). Dental treatment was successful in 9 out of 10 sessions for both groups. Minor adverse effects occurred in 16.6% and 6.8% of ID and DA sessions respectively (p = 0.01, Fisher exact test). Patients with ID were more often very disturbed during cannulation (25.4% ID vs. 3.9% DA sessions) and were less often relaxed after induction (58.9% ID vs. 90.3% DA) and during dental treatment (39.5% ID vs. 59.7% DA) (p<0.001, Fisher exact test) than patients with DA. When midazolam sedation was repeated, cooperation improved for both groups. Conscious sedation procedures using intravenous midazolam, with or without premedication and/or inhalation sedation (50% N₂O/O₂), were shown to be safe and effective in patients with intellectual disability when administered by dentists.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia, Dental - adverse effects</subject><subject>Anesthesia, Dental - methods</subject><subject>Anesthetics, Intravenous - administration & dosage</subject><subject>Anxiety</subject><subject>Anxiety Disorders - epidemiology</subject><subject>Cannulation</subject><subject>Child</subject><subject>Children</subject><subject>Cognition - physiology</subject><subject>Cognitive ability</subject><subject>Comparative analysis</subject><subject>Conscious Sedation - adverse effects</subject><subject>Conscious Sedation - methods</subject><subject>Cooperation</subject><subject>Dental Care</subject><subject>Dental insurance</subject><subject>Dentistry</subject><subject>Drugs</subject><subject>Female</subject><subject>Humans</subject><subject>Inhalation</subject><subject>Intellectual disabilities</subject><subject>Intellectual Disability - epidemiology</subject><subject>Intravenous administration</subject><subject>Learning disabilities</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Midazolam</subject><subject>Midazolam - administration & dosage</subject><subject>Middle Aged</subject><subject>Nitrous oxide</subject><subject>Patients</subject><subject>Rectum</subject><subject>Respiration</subject><subject>Safety</subject><subject>Safety and security measures</subject><subject>Side effects</subject><subject>Studies</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1trFDEUxwdRbK1-A9GAIPqwazLJ3HwQSvFSKBS8vYYzycluymyyJplq_UR-TDO729KVPsg8THLm9_9nci5F8ZTROeMNe3Phx-BgmK-9wzmlDSsFvVccso6Xs7qk_P6t9UHxKMYLSive1vXD4qDknaBN2R0Wf068i8r6MZKIGpL1jqyDV6jHgJGM0boFsS4FuEQ3USur4bcfYEWMD0SjSzAQBQEzRdbZIEci-WnTkmhrDIa8J8ovnE32EidvYweMbwlM67hGtYnHNOor4g3BrNmEHMZIwGkSwWC6elw8MDBEfLJ7HxXfPrz_evJpdnb-8fTk-Gym6q5Ms54x0Jz3VIu-B2NUr2usaEN7VKJjuje9aHjfGQptVbJKQVkzxhUKpVkDyI-K51vf9eCj3CU5SiY4LbOybTJxuiW0hwu5DnYF4Up6sHIT8GEhISSrBpSU9kw0ZWsUByFU1WMtqoqpRrQNUzB5vdudNvYr1AqnTA97pvtfnF3Khb-UvOGC8TIbvNoZBP9jxJjkykaFwwAOc7nyf5e0ZoK1VUZf_IPefbsdtYB8AeuMz-eqyVQei6YVrKs6lqn5HVR-NK6syh05FXlf8HpPkJmEv9ICxhjl6ZfP_8-ef99nX95ilwhDWkY_jFMjx31QbEGVuy4GNDdJZlROA3WdDTkNlNwNVJY9u12gG9H1BPG__mYgjg</recordid><startdate>20130805</startdate><enddate>20130805</enddate><creator>Collado, Valérie</creator><creator>Faulks, Denise</creator><creator>Nicolas, Emmanuel</creator><creator>Hennequin, Martine</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20130805</creationdate><title>Conscious sedation procedures using intravenous midazolam for dental care in patients with different cognitive profiles: a prospective study of effectiveness and safety</title><author>Collado, Valérie ; Faulks, Denise ; Nicolas, Emmanuel ; Hennequin, Martine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-b11ad33b0d4bbaffcbd6e5070bec491dbfb473b9f0a85215ca26113ce4cd17ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adults</topic><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesia, Dental - adverse effects</topic><topic>Anesthesia, Dental - methods</topic><topic>Anesthetics, Intravenous - administration & dosage</topic><topic>Anxiety</topic><topic>Anxiety Disorders - epidemiology</topic><topic>Cannulation</topic><topic>Child</topic><topic>Children</topic><topic>Cognition - physiology</topic><topic>Cognitive ability</topic><topic>Comparative analysis</topic><topic>Conscious Sedation - adverse effects</topic><topic>Conscious Sedation - methods</topic><topic>Cooperation</topic><topic>Dental Care</topic><topic>Dental insurance</topic><topic>Dentistry</topic><topic>Drugs</topic><topic>Female</topic><topic>Humans</topic><topic>Inhalation</topic><topic>Intellectual disabilities</topic><topic>Intellectual Disability - epidemiology</topic><topic>Intravenous administration</topic><topic>Learning disabilities</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Midazolam</topic><topic>Midazolam - administration & dosage</topic><topic>Middle Aged</topic><topic>Nitrous oxide</topic><topic>Patients</topic><topic>Rectum</topic><topic>Respiration</topic><topic>Safety</topic><topic>Safety and security measures</topic><topic>Side effects</topic><topic>Studies</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Collado, Valérie</creatorcontrib><creatorcontrib>Faulks, Denise</creatorcontrib><creatorcontrib>Nicolas, Emmanuel</creatorcontrib><creatorcontrib>Hennequin, Martine</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Collado, Valérie</au><au>Faulks, Denise</au><au>Nicolas, Emmanuel</au><au>Hennequin, Martine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Conscious sedation procedures using intravenous midazolam for dental care in patients with different cognitive profiles: a prospective study of effectiveness and safety</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-08-05</date><risdate>2013</risdate><volume>8</volume><issue>8</issue><spage>e71240</spage><epage>e71240</epage><pages>e71240-e71240</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The use of midazolam for dental care in patients with intellectual disability is poorly documented. This study aimed to evaluate the effectiveness and safety of conscious sedation procedures using intravenous midazolam in adults and children with intellectual disability (ID) compared to dentally anxious patients (DA). Ninety-eight patients with ID and 44 patients with DA programmed for intravenous midazolam participated in the study over 187 and 133 sessions, respectively. Evaluation criteria were success of dental treatment, cooperation level (modified Venham scale), and occurrence of adverse effects. The mean intravenous dose administered was 8.8±4.9 mg and 9.8±4.1 mg in ID and DA sessions respectively (t-test, NS). 50% N₂O/O₂ was administered during cannulation in 51% of ID sessions and 61% of DA sessions (NS, Fisher exact test). Oral or rectal midazolam premedication was administered for cannulation in 31% of ID sessions and 3% of DA sessions (p<0,001, Fisher exact test). Dental treatment was successful in 9 out of 10 sessions for both groups. Minor adverse effects occurred in 16.6% and 6.8% of ID and DA sessions respectively (p = 0.01, Fisher exact test). Patients with ID were more often very disturbed during cannulation (25.4% ID vs. 3.9% DA sessions) and were less often relaxed after induction (58.9% ID vs. 90.3% DA) and during dental treatment (39.5% ID vs. 59.7% DA) (p<0.001, Fisher exact test) than patients with DA. When midazolam sedation was repeated, cooperation improved for both groups. Conscious sedation procedures using intravenous midazolam, with or without premedication and/or inhalation sedation (50% N₂O/O₂), were shown to be safe and effective in patients with intellectual disability when administered by dentists.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23940729</pmid><doi>10.1371/journal.pone.0071240</doi><tpages>e71240</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Adults Aged Anesthesia Anesthesia, Dental - adverse effects Anesthesia, Dental - methods Anesthetics, Intravenous - administration & dosage Anxiety Anxiety Disorders - epidemiology Cannulation Child Children Cognition - physiology Cognitive ability Comparative analysis Conscious Sedation - adverse effects Conscious Sedation - methods Cooperation Dental Care Dental insurance Dentistry Drugs Female Humans Inhalation Intellectual disabilities Intellectual Disability - epidemiology Intravenous administration Learning disabilities Male Medical research Medicine Midazolam Midazolam - administration & dosage Middle Aged Nitrous oxide Patients Rectum Respiration Safety Safety and security measures Side effects Studies Surgery Treatment Outcome Young Adult |
| title | Conscious sedation procedures using intravenous midazolam for dental care in patients with different cognitive profiles: a prospective study of effectiveness and safety |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-02T22%3A00%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Conscious%20sedation%20procedures%20using%20intravenous%20midazolam%20for%20dental%20care%20in%20patients%20with%20different%20cognitive%20profiles:%20a%20prospective%20study%20of%20effectiveness%20and%20safety&rft.jtitle=PloS%20one&rft.au=Collado,%20Val%C3%A9rie&rft.date=2013-08-05&rft.volume=8&rft.issue=8&rft.spage=e71240&rft.epage=e71240&rft.pages=e71240-e71240&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0071240&rft_dat=%3Cgale_plos_%3EA478419591%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1430247387&rft_id=info:pmid/23940729&rft_galeid=A478419591&rft_doaj_id=oai_doaj_org_article_00b14728fc3a44c5be64551c74871ca7&rfr_iscdi=true |