A COMPARATIVE STUDY BETWEEN ORAL MIDAZOLAM AND NITROUS OXIDE-OXYGEN FOR DENTAL EXTRACTIONS IN PAEDIATRIC PATIENTS

BACKGROUND Fear of pain is a major deterrent to delivery of dental care in paediatric patients. Local anaesthesia delivery is one of the most frightening and painful procedure associated with highest degree of disruptive behaviour, hence the need for conscious sedation. Oral Midazolam is a popular dental sedative due to rapid absorption and clinical action with amnestic properties. Inhalation is second commonly used route for conscious sedation. Nitrous oxide is the only available inhalation agent that meets the conscious sedation criteria. Hence, this study focuses on comparing the sedation efficacy of oral Midazolam and nitrous oxide for dental extractions in children. MATERIALS AND METHODS In this randomised controlled trial study, patients aged 5 - 12 years indicated for bilateral or contralateral dental extractions were studied. After routine pre-anaesthetic workup, patients were induced with either- Group M: Oral Midazolam (0.5 mg/kg) Group N: Nitrous oxide + oxygen (50: 50) Baseline parameters, relevant intraoperative details, ease of procedure, level of sedation, acceptability by patient, anxiety level and recovery from sedation compared between both groups. RESULTS Baseline parameters like Heart Rate, Blood Pressure, SpO(2) and Respiratory Rate were comparable in both groups. However, there was significant difference in onset time of sedation and recovery between two groups. CONCLUSION Oral Midazolam due to its more effectiveness, acceptability, amnestic property and long duration of action is the preferred drug of choice for conscious sedation for dental extractions. However, nitrous oxide-oxygen can be considered as an alternate to oral Midazolam due to its anxiolytic effect, early onset and recovery time.