The Use of Intranasal Midazolam in a Special Care Dentistry Department: Technique and Cases

Prim Dent J. 2015 May;4(2):42-8.

Abstract

Intranasal (IN) administered midazolam has allowed patients who require conscious sedation but struggle to tolerate cannulation another option by which they can receive dental treatment. Studies have demonstrated that a mean bioavailability (F) of more than 73% can be achieved with IN-administered midazolam. This is due to the high vascularity within the nose. These studies have also demonstrated that peak plasma concentrations can be reached within 10 minutes. This signifies a fast onset of action. The standard bolus dose of IN midazolam is 10mg; this bolus can be reduced or increased depending on the patient's age and susceptibility to benzodiazepines. The bolus can also be repeated if adequate sedation is not reached. A protocol for administering IN midazolam is outlined and two cases are discussed.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intranasal
  • Administration, Intravenous
  • Adolescent
  • Anesthesia, Dental / methods*
  • Anesthesia, Local / methods
  • Biological Availability
  • Conscious Sedation / methods*
  • Dental Care for Disabled*
  • Dental Restoration, Permanent
  • Humans
  • Hypnotics and Sedatives / administration & dosage*
  • Hypnotics and Sedatives / pharmacokinetics
  • Male
  • Midazolam / administration & dosage*
  • Midazolam / pharmacokinetics
  • Tooth Extraction
  • Young Adult

Substances

  • Hypnotics and Sedatives
  • Midazolam