Abstract
This chapter outlines sedatives and anxiolytic agents commonly used and administered orally to sedate children for dental procedures. The salient features of nitrous oxide, chloral hydrate, meperidine, midazolam, antihistamines, and ketamine are discussed in relation to sedating children for dental procedures. Nitrous oxide is most frequently used and can be administered alone or with the other agents. Midazolam is the most frequently used oral sedative in children. Most of these agents can be used in various combinations when sedating children; however, caution must be taken when using two or more of these agents at a single appointment to decrease the likelihood of adverse events. Summary tables of the drug characteristics are also provided.
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References
Wilson S, Alcaino EA. Survey on sedation in paediatric dentistry: a global perspective. Int J Paediatr Dent. 2011;21(5):321–32.
Wilson S. A survey of the American Academy of Pediatric Dentistry membership: nitrous oxide and sedation. Pediatr Dent. 1996;18(4):287–93.
Daher A, Hanna RP, Costa LR, Leles CR. Practices and opinions on nitrous oxide/oxygen sedation from dentists licensed to perform relative analgesia in Brazil. BMC Oral Health. 2012;12:21.
Klein U, Robinson TJ, Allshouse A. End-expired nitrous oxide concentrations compared to flowmeter settings during operative dental treatment in children. Pediatr Dent. 2011;33(1):56–62.
Fraone G, Wilson S, Casamassimo PS, Weaver 2nd J, Pulido AM. The effect of orally administered midazolam on children of three age groups during restorative dental care. Pediatr Dent. 1999;21(4):235–41.
Shin YH, Kim MH, Lee JJ, Choi SJ, Gwak MS, Lee AR, Park MN, Joo HS, Choi JH. The effect of midazolam dose and age on the paradoxical midazolam reaction in Korean pediatric patients. Korean J Anesthesiol. 2013;65(1):9–13.
Sanders JC. Flumazenil reverses a paradoxical reaction to intravenous midazolam in a child with uneventful prior exposure to midazolam. Paediatr Anaesth. 2003;13(4):369–70.
Mancuso CE, Tanzi MG, Gabay M. Paradoxical reactions to benzodiazepines: literature review and treatment options. Pharmacotherapy. 2004;24(9):1177–85.
Roberts SM, Wilson CF, Seale NS, McWhorter AG. Evaluation of morphine as compared to meperidine when administered to the moderately anxious pediatric dental patient. Pediatr Dent. 1992;14(5):306–13.
Goodson JM, Moore PA. Life-threatening reactions after pedodontic sedation: an assessment of narcotic, local anesthetic, and antiemetic drug interaction. J Am Dent Assoc. 1983;107(2):239–45.
Nathan JE, Vargas KG. Oral midazolam with and without meperidine for management of the difficult young pediatric dental patient: a retrospective study. Pediatr Dent. 2002;24(2):129–38.
Garrett KM, Gan J. Enhancement of gamma-aminobutyric acidA receptor activity by alpha-chloralose. J Pharmacol Exp Ther. 1998;285(2):680–6.
Granoff DM, McDaniel DB, Borkowf SP. Cardiorespiratory arrest following aspiration of chloral hydrate. Am J Dis Child. 1971;122(2):170–1.
Donovan KL, Fisher DJ. Reversal of chloral hydrate overdose with flumazenil. BMJ. 1989;298(6682):1253.
Damle SG, Gandhi M, Laheri V. Comparison of oral ketamine and oral midazolam as sedative agents in pediatric dentistry. J Indian Soc Pedod Prev Dent. 2008;26(3):97–101.
Sullivan DC, Wilson CF, Webb MD. A comparison of two oral ketamine-diazepam regimens for the sedation of anxious pediatric dental patients. Pediatr Dent. 2001;23(3):223–31.
Moreira TA, Costa PS, Costa LR, Jesus-Franca CM, Antunes DE, Gomes HS, Neto OA. Combined oral midazolam-ketamine better than midazolam alone for sedation of young children: a randomized controlled trial. Int J Paediatr Dent. 2013;23(3):207–15.
Bui T, Redden RJ, Murphy S. A comparison study between ketamine and ketamine-promethazine combination for oral sedation in pediatric dental patients. Anesth Prog. 2002;49(1):14–8.
Pandey RK, Bahetwar SK, Saksena AK, Chandra G. A comparative evaluation of drops versus atomized administration of intranasal ketamine for the procedural sedation of young uncooperative pediatric dental patients: a prospective crossover trial. J Clin Pediatr Dent. 2011;36(1):79–84.
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Ganzberg, S.I., Wilson, S. (2015). Sedative and Anxiolytic Agents. In: Wilson, S. (eds) Oral Sedation for Dental Procedures in Children. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46626-1_4
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DOI: https://doi.org/10.1007/978-3-662-46626-1_4
Publisher Name: Springer, Berlin, Heidelberg
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