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

Abstract

Although no significant side effects were recorded, of the minor side effects reported paradoxical reaction was the most common. Due to inconsistency in side effect reporting, the authors suggest the application of a standardised adverse event reporting tool for future studies of sedation in paediatric dentistry.

Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters

“…The tool was intended to present a taxonomy of sedation outcomes which would be objective and reproducible. By adopting this taxonomy worldwide, particularly valuable in areas with neither organized sedation systems nor prior means of collecting and reporting their own outcomes, all sedation providers now have a means of tracking and sharing their outcomes through the AE sedation reporting tool database [26,29,31,[34][35][36]. This tool is a repository of sedation-related data inputted from all sedation providers worldwide and is a means to report on sedation demographics and outcomes, with the objective of presenting a hierarchical structure to predict the occurrence, risk, and outcome of adverse events ( Figure 1, Table 1, Table 2).…”

Can intravenous conscious sedation with midazolam be effective at facilitating surgical dentistry in adolescent orthodontic patients? A service evaluation

“…Paediatric morbidity and mortality have occurred using techniques and drugs out-with the strict United Kingdom (UK) regulation of dental conscious sedation;6, 18, 20 raising concerns about sedation safety. Although there has been limited research in children and adolescents within dentistry in the UK, the National Institute for Health and Care Excellence has reported midazolam as a sole-agent used in children in dentistry and other medical specialities to have a “good” safety profile 20.…”

“…Owing to the retrospective nature of this study it is not possible to deduce the exact cause of behavioural traits displayed and although co-operation was recorded prospectively, this was not using a validated scale. A system such as the Houpt Scale39 would enable more reliable behavioural assessment and standardisation of adverse incident reporting should enable robust assessment of sedation safety 18, 25…”

“…Sedation-related complications or adverse events were noted with reference to the World SIVA Adverse Sedation Event Reporting Tool25 and additional complications commonly reported in the literature (Table 3). 18 The severity of such events was categorised into either mild, moderate or severe using the approach reported by Wilson et al26…”

“…IVCS with midazolam is routinely employed in adult dentistry and a small number of studies have shown its safe and effective use in children and adolescents to facilitate a variety of dental procedures, including surgical dentistry 12, 15–18. In 2003, a randomised controlled cross-over trial by Wilson et al 12.…”