250 - Retrospective Evaluation of Moderate Sedation visits that Used Meperidine and Hydroxyzine Drug Regimens with Oral and Intranasal Midazolam

Retrospective Evaluation of Moderate Sedation Visits that Used Meperidine and Hydroxyzine Drug Regimens with Oral and Intranasal Midazolam 
Jain G, Jones RS

Division of Pediatric Dentistry, Department of Surgical and Developmental Sciences, School of Dentistry, University of Minnesota, Moos Health Sciences Tower, 515 Delaware St SE, Minneapolis, MN 55455.

Abstract

Purpose: To compare the additive effects that oral (PO) and Intranasal (IN) Midazolam (MID) have on moderate sedation outcomes when combined with PO meperidine and hydroxyzine (MEP-H) in multidrug regimens.

Methods: In this IRB approved study, a retrospective cross-sectional analysis examined moderate sedation outcomes and patient factors that predicted visit outcomes in pediatric dental patients at the university of Minnesota pediatric dentistry residency clinic. The chart review examined three regimens (MEP-H; MEP-H with PO MID; MEP-H with IN MID) during a time period between July 2015 to July 2020.
Outcome assessment focused on 1) Behavior during local anesthesia, sedation visit effectiveness, sedation treatment completion, treatment time and discharge time. A multivariable logistic regression analyses assessed predictive variables (e.g., age, gender, preoperative behavior, BMI, heart rate during LA, sedation regimens) to sedation visit effectiveness.

Results: We completed the data evaluation and study involved retrospective evaluation of 508 patient charts..

Conclusion: Based on this study’s results, the following conclusions can be made:
1. Meperidine based sedation regimens had higher likelihood of sedation effectiveness over single agent midazolam.
2. This current retrospective study suggests that MEP-H-(IN)MID may reduce discharge time compared to MEP-H-(PO)MID while providing comparable sedation effectiveness.
2. All sedation drug regimens, including MEP-H-(IN)MID, had high levels of oxygen saturation during the entire course of the sedation appointment.
2. Prospective randomized clinical trials are needed to further investigate MEP-H-(IN)MID and MEP-H-(PO)MID.