Premedication with melatonin vs midazolam in anxious children. - Pub...

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http://www.ncbi.nlm.nih.gov/pubmed/18616492

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Paediatr Anaesth. 2008 Jul;18(7):635-41. doi: 10.1111/j.1460-9592.2008.02608.x.

Premedication with melatonin vs midazolam in anxious children.

Isik B1, Baygin O, Bodur H.

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Abstract
AIM: Failure of dental treatment caused by anxiety is a common problem in children. Oral midazolam has
been the most commonly used premedication for pediatric patient but the use of midazolam may be
associated with paradoxical reactions in children. Melatonin may induce a natural sleepiness and improve
sedation. We have investigated premedication with melatonin compared with midazolam in children under
nitrous oxide/oxygen (N(2)O/O(2)) sedation for dental treatment.
METHODS: In a randomized study, 60 children received either 3 mg of melatonin [Melatonina (3 mg(R))
60 min before the procedure (n = 15); group I], 0.5 mg.kg(-1) melatonin 60 min before the procedure (n =
15; group II), 0.75 mg.kg(-1) midazolam [Dormicum (15 mg/3 ml (R)) 15 min before the procedure (n =
15); group III] or 3 ml of 0.09 NaCl 15 min (n = 7) or 60 min before the procedure (n = 8; group IV) orally.
The children were sedated with 40/60% N(2)O/O(2) inhalation. The heart rate and O(2) saturation were
monitored during the treatment period. The level of sedation was assessed according to the Ramsay
Sedation Scale. The children's sedation success during dental treatment was classified. The sedation
success and other sedation-related events recorded. Comparisons among the four groups were made
using one-way anova or Kruskal-Wallis test, and if any significant differences were noted, the Tukey's
HSD or Mann-Whitney U-test were used for intergroup comparisons. All differences were considered
significant at P < 0.05.
RESULTS: The evaluation of sedation success was as follows: group I: satisfactory (n = 1), average
satisfactory (n = 4), and unsatisfactory (n = 10); group II: satisfactory (n = 2), average satisfactory (n =
3), and unsatisfactory (n = 10); group III: satisfactory (n = 9), average satisfactory (n = 6); and group IV:
satisfactory (n = 1), average satisfactory (n = 3), and unsatisfactory (n = 11).
CONCLUSION: In these doses and clinical conditions, melatonin was similar to that of placebo and did
not contribute to N(2)O/O(2) sedation of anxious children.
PMID: 18616492 [PubMed - indexed for MEDLINE]

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Premedication with melatonin vs midazolam in anxious children. - Pub...

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