Midazolam: A Step-by-Step Clinical Protocol

A step-by-step protocol provides a channel towards a successful sedation appointment. It also aids the clinician retrospectively evaluate the sedation session for improved future outcomes. Minimal/moderate sedation with midazolam is unlike deep sedation or general anesthesia. There will be a lot of “stop and proceed” phases requiring skill, patience, and intelligent clinical maneuvering. A protocol will also help the clinician fine tune this aspect. This chapter will start with a description of the objective signs of sedation, permitting the initiation of treatment. It will further take the reader through a step-by-step clinical protocol of treatment under midazolam. Important issues like parental presence in the operatory, combining midazolam with inhalation sedation, the role of protective stabilization, intraoperative monitoring, local anesthesia, discharge criteria, post-operative instructions, and documentation will also be addressed briefly.