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Lim SW, So E, Yun HJ, et al. Analysis of the effect of oral midazolam and triazolam premedication before general anesthesia in patients with disabilities with difficulty in cooperation. J Dent Anesth Pain Med. 2018;18(4):245-254doi: 10.17245/jdapm.2018.18.4.245.
Lim, S. W., So, E., Yun, H. J., Karm, M. H., Chang, J., Lee, H., Kim, H. J., & Seo, K. S. (2018). Analysis of the effect of oral midazolam and triazolam premedication before general anesthesia in patients with disabilities with difficulty in cooperation. Journal of dental anesthesia and pain medicine, 18(4), 245-254. https://doi.org/10.17245/jdapm.2018.18.4.245
Lim, Seon Woo, et al. "Analysis of the effect of oral midazolam and triazolam premedication before general anesthesia in patients with disabilities with difficulty in cooperation." Journal of dental anesthesia and pain medicine vol. 18,4 (2018): 245-254. doi: https://doi.org/10.17245/jdapm.2018.18.4.245
Lim SW, So E, Yun HJ, Karm MH, Chang J, Lee H, Kim HJ, Seo KS. Analysis of the effect of oral midazolam and triazolam premedication before general anesthesia in patients with disabilities with difficulty in cooperation. J Dent Anesth Pain Med. 2018 Aug;18(4):245-254. doi: 10.17245/jdapm.2018.18.4.245. Epub 2018 Aug 28. PMID: 30186971; PMCID: PMC6115375.
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J Dent Anesth Pain Med. 2018 Aug;18(4):245-254. doi: 10.17245/jdapm.2018.18.4.245. Epub 2018 Aug 28.

Analysis of the effect of oral midazolam and triazolam premedication before general anesthesia in patients with disabilities with difficulty in cooperation.

Journal of dental anesthesia and pain medicine

Seon Woo Lim, Eunsun So, Hye Joo Yun, Myong-Hwan Karm, Juhea Chang, Hanbin Lee, Hyun Jeong Kim, Kwang-Suk Seo

Affiliations

  1. Department of Dental Anesthesiology, Seoul National University, School of Dentistry, Seoul, Korea.
  2. Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea.
  3. Special Care Clinic, Seoul National University Dental Hospital, Seoul, Korea.
  4. Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea.

PMID: 30186971 PMCID: PMC6115375 DOI: 10.17245/jdapm.2018.18.4.245

Abstract

BACKGROUND: When performing dental treatment under general anesthesia in adult patients who have difficulty cooperating due to intellectual disabilities, anesthesia induction may be difficult as well. In particular, patients who refuse to come into the dental office or sit in the dental chair may have to be forced to do so. However, for adult patients with a large physique, physical restraint may be difficult, while oral sedatives as premedication may be helpful. Here, a retrospective analysis was performed to investigate the effect of oral sedatives.

METHODS: A hospital-based medical information database was searched for patients who were prescribed oral midazolam or triazolam between January 2009 and December 2017. Pre-anesthesia evaluation, anesthesia, and anesthesia recovery records of all patients were analyzed, and information on disability type, reason for prescribing oral sedatives, prescribed medication and dose, cooperation level during anesthesia induction, anesthesia duration, length of recovery room stay, and complications was retrieved.

RESULTS: A total of 97 patients were identified, of whom 50 and 47 received midazolam and triazolam, respectively. The major types of disability were intellectual disabilities, autism, Down syndrome, blindness, cerebral palsy, and epilepsy. Analyses of changes in cooperation levels after drug administration showed that anesthesia induction without physical restraint was possible in 56.0% of patients in the midazolam group and in 46.8% of patients in the triazolam group (P = 0.312).

CONCLUSIONS: With administration of oral midazolam or triazolam, general anesthesia induction without any physical restraint was possible in approximately 50% of patients, with no difference between the drugs.

Keywords: Dental Treatment; General Anesthesia; Intellectual Disability; Midazolam; Sedative Premedication; Triazolam

Conflict of interest statement

NOTEThe authors have no conflicts of interest.

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