Intranasal Remifentanil as an Adjunct to Oral Midazolam Sedation in Pediatric Dental Patients

Oral sedatives are often required for children who require dental restoration. Most children are able to receive this in the dental office, often using nitrous oxide with minimal sedation to facilitate the procedure. However, there are children who will not cooperate during the examination process or during the actual dental procedure without sedation [1]. This can be due to young age, behavior issues or non-compliant behavior. As a result, these children are scheduled for oral moderate sedation in the office setting. We routinely use oral midazolam as our sedation method. Midazolam has a wide safety margin and is effective in about 80% of the patients [2]. We use a dose of 1 mg/kg up to a maximum of 20mg, wait 30 minutes where the child is monitored in the preoperative area before going into the operating room.