Effect of drinks that are added as flavoring in oral midazolam premedication on sedation success

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Abstract

Background

Midazolam is one of the most frequently used agents for sedation in pediatric dentistry. The injectable form of midazolam can also be given orally. However, its bad taste has negative effects on ingestion of the drug. In this study, we aimed to evaluate the effect of drinks which were added to mask the bitter taste of midazolam for drug acceptance and sedation.

Methods

In the laboratory; the pH values of 2.5 ml midazolam (15 mg·3 ml−1) and the mixtures of Pepsi Cola®, 10% sodium citrate, fresh pomegranate juice, and fresh grapefruit juice in equal volumes were measured. Seventy-five patients between 2 and 8 years of age who were assessed to have anxiety with the Frankl Behavior Scale and whose dental treatment was planned under sedation were randomly divided into five groups. Pepsi Cola (Group I), 10% sodium citrate (Group II), pomegranate juice (Group III), and grapefruit juice (Group IV) which were added to 0.75 mg·kg−1 midazolam in equal volumes, and (Group V) 0.75 mg·kg−1 midazolam given orally to children. The drug compliance of children was evaluated. After 15 min, 4–5 l·min−1 of N2O: O2 (40: 60) inhalation was started via a nasal hood. During the procedure, heart rate, and SpO2 were monitored with pulse oximetry and sedation levels with the Ramsay Sedation Scale (RSS). Anesthetist, dentist, and parental satisfaction levels were recorded.

Results

The groups had similar demographics, drug ingestion was better in Groups I and II, but the mean RSS was the highest in Group II (P< 0.05).

Conclusions

As well as making drug ingestion much simpler, the addition of sodium citrate to the midazolam administered orally to the children increased the effectiveness of sedation.

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