The use of intranasal midazolam in the treatment of paediatric dental patients

Summary The aim of this study was to assess the use of intranasal midazolam in paediatric dental patients requiring extractions or simple surgical procedures who may otherwise have required a general anaesthetic. Twenty children aged between 2–9 years who required simple surgical procedures were given 0.25 mg.kg−1 midazolam, administered using a MAD® (Mucosal Atomization Device; Wolfe Tory Medical Inc., Salt Lake City, UT, USA). Compliance with the full dose was achieved in 14 patients, 13 of whom completed the treatment. One of two patients who allowed only partial administration completed the treatment and three patients did not comply. The mean time to starting treatment was 13 min (range 6–25 min) and patients were discharged after a mean of 46 min (range 25–67 min). Physiological parameters remained stable throughout with no clinically significant episodes of desaturation. One patient vomited at home postoperatively. Midazolam in a dose of 0.25 mg.kg−1 administered intranasally provided adequate anxiolysis for the majority of children, allowing them to complete their treatment.