Comparison of rectal midazolam and diazepam for premedication in pediatric dental patients

Rectally administered midazolam (0.35 mg/kg) and diazepam (0.70 mg/kg) were compared with each other and with placebo for preanesthetic medication in children undergoing dental extractions. All rectal medications were very well accepted, but mask acceptance, improvement in anxiety, and sedation were best in the midazolam group. Improvement in anxiety and sedation were significantly better in the two drug groups than in those patients who had received placebo. Thirty minutes after rectal administration of midazolam, patients showed a decrease in both systolic and diastolic blood pressure and heart rate. Although these decreases differed significantly from the premedication values, they were probably of little clinical importance. Only minor adverse effects were observed in this study. Overall rectally administered midazolam appeared to be somewhat more efficacious than diazepam.