Ensaio clínico randomizado controlado triplo cego para avaliação da ansiedade e estresse de crianças submetidas à sedação com midazolam oral durante tratamento odontológico
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2013-02-26
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Universidade Federal de Goiás
Resumo
The fear and anxiety represent a barrier for dental care and can cause behavioral and
physiological changes. These changes can be evaluated through behavioral scales and the
measurement of salivary cortisol levels. The aim of this study was to evaluate the level of
salivary cortisol in children during restorative dental treatment under moderate sedation with
midazolam and taken a placebo and verify the correlation between this physiological measure
and the assessment of the behavior conducted through the scale Ohio State University
Behavioral Rating Scale (OSUBRS). A randomized controlled crossover triple-blind clinical
trial was conducted with 18 healthy children from 2 to 5-year olds with necessity of at least
two sessions of restorative dental treatment. Each child was undergo treatment under sedation
with 1mg/kg oral midazolam in one session and the other with a placebo and in both sessions
protective stabilization was associated. The assessment of child behavior was conducted from
videos of clinical sessions using the scale of OSUBRS and the salivary cortisol level was
evaluated in 4 moments on the two sessions (waking up, on arrival at the Dental School (DS),
25 minutes after the anesthesia and 25 minutes after finishing the procedure). The saliva
samples were analyzed by the Enzyme Immunoassay test to get the mean salivary cortisol
level. The results showed that the salivary cortisol level was lower when the children had
received midazolam than when they had received the placebo at the moment of anesthesia
(p=0.004). It was! Observed greater variation in cortisol level when the children received
placebo than when they received midazolam. However, there were no differences between
salivary cortisol levels observed in the four moments during treatment with sedation (p =
0.319) or placebo (p = 0.080). Regarding the child behavior it was not observed improvement
during the treatment with sedation compared with placebo. The salivary cortisol levels
showed no statistically significant correlation with the child’s behavior assessed by the scale
OSUBRS during dental treatment under sedation or placebo. Therefore it was concluded that
the oral midazolam dose of 1.0 mg/kg is effective in reducing the levels of salivary cortisol of
children from 2 to 5-year olds during restorative dental treatment. However, this reduction in
the level of cortisol in saliva did not reflect in better clinical behavior of these children.
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GOMES, H.S. Ensaio clínico randomizado controlado triplo cego para avaliação da ansiedade e estresse de crianças submetidas à sedação com midazolam oral durante tratamento odontológico. 2013. 89 f. Dissertação (Dissertação em Odontologia) - Universidade Federal de Goiás, Goiânia, 2013.