Conscious sedation with midazolam in a dental patient with a spastic nerve/muscle disorder
A case is presented in which intravenous midazolam was titrated to sedate a patient with a spastic nerve/muscle disorder during a post and crown preparation procedure. A 29-year-old woman with uncontrolled limb and body movements, possibly due to brain trauma during birth, was given midazolam in small incremental doses, not exceeding 0.5 mg at approximate intervals of 10 minutes after receiving a bolus dose of 0.75 mg at the start of the procedure. The 0.5 mg dose was given every time limb/body movements increased. The total dose of 0.1 mg/Kg, often given as a bolus for sedation in dentistry, was not exceeded during the procedure. No adverse effects were observed, and the patient remained well sedated and cooperative during the entire procedure.
In conclusion, the patient, dentist, and anesthesiologist were extremely happy with the sedative and restorative procedure. This underlines the usefulness of the midazolam titration technique in dental patients with spastic nerve/muscle disorders. [M.O.]
van der Bijl, P., and J.A. Roelofse, Ann Dent, 1:53, 1994