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

How families prepare their children for tooth extraction under general anaesthesia: Family and clinical predictors of non‐compliance with a ‘serious game’

“…Most notably, this study is one of the few to recruit and retain ‘hard‐to‐reach families . The sample profile matches those reported in previous studies of this ECC child GA patient cohort in the UK . However, non‐English speaking families were excluded and so some of the immigrant and ethnic communities within London were not represented.…”

“…In the UK, Early Childhood Caries (ECC) often leads to children being admitted to hospital for tooth extraction under general anaesthesia; over 60 000 in 2012/13 . Previous studies show that many of these children are anxious, need multiple extractions, and also have psychological and behavioural disturbances . An anaesthetic guideline recommends that the children are offered psychological preparation but these families tend not to readily attend appointments so, delivering this is difficult to achieve, especially in this busy fast‐through‐put day surgery service.…”

“…5 Previous studies show that many of these children are anxious, need multiple extractions, and also have psychological and behavioural disturbances. 6,7 An anaesthetic guideline recommends that the children are offered psychological preparation 8 but these families tend not to readily attend appointments so, delivering this is difficult to achieve, especially in this busy fast-through-put day surgery service. Campbell et al published one of the first RCTs that used a serious game to prepare them 9,10 but it was delivered by a nurse, in the hospital.…”

Management of respiratory symptoms in paediatric palliative care

“…Buccal midazolam, used to manage anxiety in dental practice [27], is often prescribed in paediatric palliative care, but there are no studies assessing the benefit in paediatric dyspnoea. Intranasal midazolam may be more acceptable to children than the buccal route [28] but again no studies have assessed its role in dyspnoea.…”

Sedation of Pediatric Patients for Dental Procedures: The United States, European, and South American Experience

“…Interestingly, a recent Cochrane review suggested that the presence of parents during induction of GA does not reduce the child's anxiety and that parental acupuncture, clown doctors, hypnotherapy, low sensory simulation, and handheld video games need to be investigated further [ 190 ]. Surprisingly, even the use of a premedication such as midazolam has met with limited success by comparison [ 191 ].…”