499 - Comparing Oral Sedation Events in Pediatric Patients: A Randomized Clinical Trial Pilot Study

Purpose: Compare incidence of adverse sedation-related events in three different multi-agent oral sedation regimens in pediatric dental patients.


Methods: Fifteen ASA I patients, aged 3 to 8 years, were independently scheduled to undergo oral sedation. Subjects were randomly allocated to one of three groups. The first group received a three-medication cocktail of Midazolam, Meperidine and Hydroxyzine (MZ/M/H), while the second and third groups received atwo-medication cocktail of (MZ/H) and (M/H), respectively. All treatments were completed using nitrous oxide. The treating dentists answered a questionnaire regarding the perioperative period. Parents received two phone interviews at two time points after sedation. Data Analysis included descriptive and inferential statistics and chi-square tests.


Results: The pilot study included five patients in each group. A total of 45 surveys and 1050 questions related to adverse sedation-related events were collected, with an overall response rate of 100%. When comparing the three medication regimens, no significant differences were observed in the amount and frequency sleeping, gastrointestinal side effects, overall activity level, residual central nervous system alterations, respiratory depression, and existence of a paradoxical reaction at different time points post sedation (p > .05). It was noted that parents whose children were sedated with the triple cocktail regimen reported higher incidence of adverse related events.


Conclusions: The results are promising in demonstrating that oral sedation regimens containing Meperidine, Midazolam and Hydroxyzine are relatively safe; however, postoperative monitoring remains essential. Larger studies utilizing different medication combinations are warranted.