Is intravenous conscious sedation for surgical orthodontics in children a viable alternative to general anaesthesia? – a case review

Reported side effects of intravenous midazolam sedation when used in paediatric dentistry: a review

“…The guidelines do not provide a lower age limit for sedation with intravenous midazolam. Dorman et al . set the lower age limit of patients in their study at 12 years, in part because the authors felt that patients at this age were intellectually developed enough to cope with the sedation.…”

“…Excessive body movement was therefore (14) 33 minor side effects reported in total (19.5%) Table 6. Summary of non-randomised studies [27][28][29][30]32,34 . Side effects of IV midazolam in paediatric dentistry Dose ranged from 1.5 to 10 mg 0 118 (17) 118 minor side effects reported in total (16.8%) *Where both patient numbers and number treatment episodes were given, treatment episodes were used in the calculation of the overall sum.…”

“…The guidelines do not provide a lower age limit for sedation with intravenous midazolam. Dorman et al 28 set the lower age limit of patients in their study at 12 years, in part because the authors felt that patients at this age were intellectually developed enough to cope with the sedation. The Standing Committee on Sedation for Dentistry (SCSD) describes the use of any form of conscious sedation other than nitrous oxide for children under 12 years of age as an 'alternative technique' 35 .…”

“…In six of the studies in this review, an anaesthetist acted as the sedationist 11,[23][24][25]29,34 , in three studies, the dentist was the sedationist 26,28,30 , and in two studies, this information was not recorded 27,32 . The authors agree that the sedationist should be appropriately trained in paediatric cannulation, IV sedation and, at the minimum, be trained in intermediate paediatric life support.…”

Paediatric conscious sedation: views and experience of specialists in paediatric dentistry

“…22 Randomised control trials have examined the use of intravenous midazolam as an alternative or adjunct to other sedative agents [23][24][25] and have found it to be a safe and effective alternative to general anaesthetic for surgical orthodontic extractions. 26 While there is insuffi cient scientifi c evidence to support the routine use of intravenous sedation for dentistry in children under the age of 16 years, it can be a useful technique in the hands of skilled operators in specialist units. 4 When appropriately used, sedation with oral midazolam can be an effective means of facilitating dental care for young children.…”