Bravo MCA, Flores ZRM, Barradas VJR

Language: English
References: 0
Page: 41-45
PDF size: 263.50 Kb.

Text Extraction

The objective of this study is to demonstrate the benefits of sedation with oral midazolam in preschoolers requiring minor surgery, trauma or odonthologycal treatments.
Material and method: A controlled clinical study was designed, prospective, transverse, random simple of cohorts, with a sample of 200 children from 2 to 5 years old, divided in 2 groups that required treatment for traumatism, wounds, abscesses or odonthologyc in more than 3 teeth. Patients under treatment with antiepileptics or neuroleptycs and patients without anxiefy were discarded, as well as those that didn’t sign the informed consent. Group I was handled under sedation with 400 mcg/kg/dose of oral midazolam; Group II was the control group, using several subjection forms. Both they were assisted with usual techniques for each lesion, local anesthesia included. Anxiety was evaluated, sedation levels (latency, effective time and recovery), secondary effects, amnesia and vital signs during the treatment. The statistical evaluation was made with the software program Epi Info 2002.
Results: Mean of age was 3.5 years with prevalence of male sex (52%); the assisted lesions were: 74 sutures, 36 fracture or luxation reductions, 21 abscesses, 29 traumatic cures and 40 dental treatments. In patients under sedation, the mean were: time of latency 29 min, sedation 65 min and recovery 15 min. The sedation effectiveness was excellent in 93% and 92% of total amnesia. The success in anxiolysis and amnesia was successful with value of Chi2 with p‹0.00001 and Fisher exact test p‹0.0001. Group II showed important anxiety with alteration of vital signs and difficult handling in 95% of the cases, while the group I had normality of signs and 2 cases only presented drowsiness for 45 minutes after the time of recovery.
Discussion: Anxiety, anguishes and behavioral stress associated to medical and surgical procedures is frequent in almost all the children, being the preschoolers the most sensitive to have higher levels and loss of control, when not understanding its lesion and the required treatment, what hinders its appropriate attention, even using technical of subjection that for themselves, they are aggressors.
This study shows the benefits of using a technique of sure sedation, with what the therapeutic maneuvers are facilitated with a time average of sedation of 1 hr, minimizing the stress in the control visit consultations, being a simple, effective technique and of low cost.