Sedation
Raymond Lee, DDS
Chief Dental Resident
University of Washington, Seattle, WA
University of Washington
SEATTLE, Washington, United States
Travis M. Nelson, DDS, MSD, MPH
Chair and Program Director
University of Washington Department of Pediatric Dentistry
University of Washington
Seattle, Washington, United States
Purpose: The primary objective of this study was to assess the effects of oral sedation using midazolam and hydroxyzine with and without meperidine on sedation outcomes in pediatric dental patients. The secondary objective was to assess the relationship between child temperament and sedation outcomes.
Methods: This single-blind randomized pilot study recruited children between the ages of 3-7 who were scheduled to receive restorative dental treatment with oral sedation. Participants were randomly assigned to receive a regimen of midazolam (0.5mg/kg) and hydroxyzine (1.0 mg/kg) with or without meperidine (1.5 mg/kg). Parents completed the Child Behavior Questionnaire Short Form (CBQ-SF) to assess temperament.
Results: The sample included 37 children [Age (Mean±SD)=69.19±14.05 months], split fairly evenly into the two groups. Overall, the sedation success rate was 54%. There were no significant differences in sedation outcome regarding age, sex, insurance status, sedation regimen, isolation method, and procedure. Children who displayed higher soothability experienced higher rates of success, an effect that was more pronounced in the non-narcotic regimen group (P < 0.01). Children with high pre-operative Frankl behavioral ratings were also more likely to have successful sedation outcomes (P < 0.01).
Conclusions: Overall, there was a low rate of success in this study and a relatively small sample size. However, the results suggest that pre-procedure behavior and the temperament characteristic of soothability may be worth exploring in more detail as a predictor of sedation success.