The effect of transmucosal 0.2mg/kg Midazolam premedication on dental anxiety, anaesthetic induction and psychological morbidity in children undergoing general anaesthesia for tooth extraction

Hosey, M.T., Asbury, A.J., Bowman, A.W. , Millar, K., Martin, K., Musiello, T. and Welbury, R.R. (2009) The effect of transmucosal 0.2mg/kg Midazolam premedication on dental anxiety, anaesthetic induction and psychological morbidity in children undergoing general anaesthesia for tooth extraction. British Dental Journal, 207, E2. (doi: 10.1038/sj.bdj.2009.570) (PMID:19574992)

Abstract

<b>Background:</b> The project aims were to evaluate the benefit of transmucosal Midazolam 0.2mg/kg pre-medication on anxiety, induction behaviour and psychological morbidity in children undergoing general anaesthesia (GA) extractions. <b>Method:</b> 179 children aged 5-10 years (mean 6.53 years) participated in this randomised, double blind, placebo controlled trial. Ninety children had Midazolam placed in the buccal pouch. Dental anxiety was recorded pre operatively and 48 hours later using a child reported MCDAS-FIS scale. Behaviour at anaesthetic induction was recorded and psychological morbidity was scored by the parent using the Rutter Scale pre-operatively and again one-week later. Subsequent dental attendance was recorded at one, three and six months after GA. <b>Results:</b> Whilst levels of mental anxiety did not reduce overall, the most anxious patients demonstrated a reduction in anxiety after receiving midazolam premedicationmay (p=0.01). Neither induction behaviour nor psychological morbidity improved. Irrespective of group, parents reported less hyperactive (p= 0.002) and more prosocial behaviour (p=0.002) after the procedure:;, older children improved most (p=0.048), Post GA Dental attendance was poor and unrelated to after the procedure and unaffected by premedication. <b>Conclusion:</b> 0.2mg/kg buccal Midazolam provided some evidence for reducing anxiety in the most dentally anxious patients. However, induction behaviour, psychological morbidity and subsequent dental attendance were not found to alter between the premedication groups.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Musiello, Mrs Toni and Asbury, Dr Adrian and Bowman, Prof Adrian and Welbury, Professor Richard and Millar, Professor Keith and Hosey, Dr Marie
• Authors: Hosey, M.T., Asbury, A.J., Bowman, A.W., Millar, K., Martin, K., Musiello, T., and Welbury, R.R.
• Subjects: R Medicine > RK Dentistry; R Medicine > RJ Pediatrics
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: British Dental Journal
• Journal Abbr.: BDJ
• Publisher: Nature Publishing Group
• ISSN: 0007-0610
• ISSN (Online): 1476-5373
• Published Online: 03 July 2009
• Copyright Holders: Copyright © 2009 Nature
• First Published: First published in British Dental Journal 207(E2)
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
35848	1	Clinical evaluation of the effects of chair-side paediatric dental general anaesthesia and midazolam sedation on cognitive function, anxiety and access to future dental care.	Keith Millar	Scottish Executive Health Department (SEHHD-CSO)	CZH/4/139	Mental Health and Wellbeing