Midazolam intranasal em odontopediatria: uma revisão crítica e sugestão de protocolo operacional padrão

Abstract

Fear and anxiety facing dental treatment is one of the biggest challenges in pediatric dentistry, affecting about 5% to 20% of children under normal conditions in the world. Pharmacological stabilization represents an effective alternative to dental treatment in uncooperative children, avoiding the need for an operating room and general anesthesia. This study sought to describe the pharmacological and clinical aspects of the use of intranasal midazolam in pediatric dentistry and suggests a standard operating protocol (SOP) used at the Pediatric Dentistry outpatient clinic of the Department of Dentistry at the Federal University of Sergipe (DOD/UFS). Midazolam is an effective medication with an adequate safety profile for use in sedation in pediatric dentistry, promoting anterograde amnesia. However, the patient’s risk assessment must always be considered, and the safety dose must always be respected. The incidence of adverse events, such as paradoxical reactions and respiratory events, and the risk of oversedation increase with increasing doses. The intranasal route for outpatient sedation with midazolam represents an advantageous alternative in pediatric dentistry because it is not an invasive route, has a rapid onset of action that is similar to that of injectable administration with shorter recovery time and is subject to rapid reversal with the use of antagonistic medication. , as described in the SOP used at the Pediatric Dentistry outpatient clinic at DOD/UFS, which was able to optimize its execution and safely reverse it in pediatric patients.