{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:10:34Z","timestamp":1790712634189,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,3,21]],"date-time":"2021-03-21T00:00:00Z","timestamp":1616284800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Gerodontology"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe the efficacy and safety of intranasal midazolam for sedation during essential dental treatment of geriatric patients with major neurocognitive disorder (MND) and care\u2010resistant behaviour (CRB).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Dental treatment is often impossible in geriatric MND patients with CRB. Intranasal midazolam may provide a non\u2010invasive sedation method, but there is currently no information on its use in geriatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this observational study, we included geriatric patients with severe MND and CRB needing urgent dental treatment. Each patient received 5\u00a0mg midazolam intranasally. Agitation\/sedation levels, heart rate, respiration rate and oxygen saturation were recorded at 5\u2010minute intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty two patients were included. Mean age was 84 (\u00b17) years. Mean (SD) time to treatment start was 13 (\u00b15) minutes, and mean time to maximum sedation 17 (\u00b111) minutes. Sedation was sufficient to enable dental treatment to be completed in 31 (97%) patients. Anxiolysis\/light sedation occurred in 16 (50%) patients, and moderate to deep sedation occurred in 16 (50%) patients. No patients suffered from apnoea, although 3 patients required a chin\u2010lift manoeuvre. Hypoxaemia occurred in 1 of these patients and in 2 other patients without airway obstruction. All patients recovered uneventfully. In a regression model, age, weight and other sedative medication use were found not to be associated with maximum sedation depth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Of 5\u00a0mg intranasal midazolam facilitates treatment of geriatric patients with MND in the comfort of their own environment. More information is needed to guide titration to balance the desired sedation level and patient safety.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ger.12550","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T02:48:45Z","timestamp":1616381325000},"page":"161-169","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intranasal midazolam for the sedation of geriatric patients with care\u2010resistant behaviour during essential dental treatment: An observational study"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1216-0576","authenticated-orcid":false,"given":"Clemens R. M.","family":"Barends","sequence":"first","affiliation":[{"name":"Department of Anesthesiology University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony R.","family":"Absalom","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery University of Groningen University Medical Center Groningen  Groningen The Netherlands"},{"name":"Department for Gerodontology Dental School University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,21]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Alzheimer Nederland. Factsheet alzheimer. https:\/\/www.alzheimer\u2010nederland.nl\/sites\/default\/files\/directupload\/factsheet\u2010dementie\u2010algemeen.pdf. Updated 2017. Accessed 08\/07:2018."},{"key":"e_1_2_9_3_1","unstructured":"WHO.Dementia. Dementia Web site. https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/dementia. Published 9\/19\/2019. Updated. 2019. 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Continuum of depth of sedation: Definition of general anesthesia and levels of Sedation\/Analgesia. www.asahq.org Web site. https:\/\/www.asahq.org\/standards\u2010and\u2010guidelines\/continuum\u2010of\u2010depth\u2010of\u2010sedation\u2010definition\u2010of\u2010general\u2010anesthesia\u2010and\u2010levels\u2010of\u2010sedationanalgesia. Published 10\/23\/2019. Updated 2019. 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