Buccal versus intranasal midazolam sedation for pediatric dental patients

The purpose of this randomized, controlled, crossover clinical trial was to evaluate and compare the behavioral differences resulting from the sedative effects of atomized buccal (transmucosal) and atomized intranasal (parenteral) midazolam (0.3 mg/kg) as a method for sedation of pediatric dental patients.

Twenty-five 36- to 72-month-old patients were randomly selected and divided into two groups that were sedated with either atomized buccal in the first visit or intranasal midazolam in the second visit (0.3 mg/kg). Patient be- havior was rated, and drug acceptance by method of administration was determined.

There were no statistically significant differences between both groups in maximum working time. There were significant differences between both groups in drug acceptance (P=.008) and onset time (P=.00). The statistical differences between the two groups were not significant in all behavior rating scales, except for the crying rating scale, since the buccal group showed more crying.

Atomized buccal and intranasal midazolam are both effective for sedation of pediatric dental patients and have the same maximum working time. However, atomized intranasal is more acceptable by children, has faster onset time, and children demonstrate less crying.