Ritwik Priyanshi, Cao Linda T, Curran Ronald, Musselman Robert J
Department of Pediatric Dentistry, Louisiana State University Health Sciences Center (LSUHSC) School of Dentistry, New Orleans, LA 70119, USA.
Anesth Prog. 2013 Summer;60(2):54-9. doi: 10.2344/0003-3006-60.2.54.
Moderate oral sedation is used in pediatric dentistry for safe delivery of dental care to children. However, there is a paucity of data on the effects of pediatric dental sedations after discharge of children from the dental office. The purpose of this study was to evaluate and compare the incidence of adverse events occurring with meperidine and hydroxyzine versus midazolam alone 8 and 24 hours after sedation in pediatric dental patients. In this prospective study, a convenience sample of 46 healthy children presenting to a private pediatric dental practice for dental treatment needs was selected. A telephone survey of the parents of children sedated with either meperidine and hydroxyzine or midazolam alone was conducted 8 and 24 hours after the administration of sedation medications. Data analysis included descriptive statistics, frequency and proportion analysis, and Fisher exact test. Forty children were sedated with meperidine and hydroxyzine, and 6 who were sedated with midazolam. In both groups, 50% of the children slept in the car on the way home. Three children in the meperidine and hydroxyzine group vomited in the car. A significantly larger proportion of children in the meperidine and hydroxyzine group experienced prolonged sleep at home (P = .015). More children in the midazolam group exhibited irritability in the first 8 hours (P = .07). There were no statistical differences between the 2 groups with respect to incidence of pain, fever, vomiting, sleeping in the car, snoring, and difficulty in waking up. The lingering effects of orally administered sedation medications can lead to prolonged sleep, irritability, and vomiting in children after they have been discharged from the dental clinic. Most of these events occurred within the first 8 hours, but in some children the effects were seen up to 24 hours later.
在儿童牙科中，中度口腔镇静用于安全地为儿童提供牙科护理。然而，关于儿童从牙科诊所出院后牙科镇静效果的数据却很匮乏。本研究的目的是评估和比较在儿科牙科患者镇静后8小时和24小时，哌替啶和羟嗪联合使用与单独使用咪达唑仑时不良事件的发生率。在这项前瞻性研究中，选取了46名到一家私立儿科牙科诊所就诊有牙科治疗需求的健康儿童作为便利样本。在给予镇静药物8小时和24小时后，对单独使用哌替啶和羟嗪或咪达唑仑镇静的儿童家长进行了电话调查。数据分析包括描述性统计、频率和比例分析以及Fisher精确检验。40名儿童使用哌替啶和羟嗪进行镇静，6名儿童使用咪达唑仑进行镇静。在两组中，50%的儿童在回家途中在车内睡着了。哌替啶和羟嗪组有3名儿童在车内呕吐。哌替啶和羟嗪组中经历在家中长时间睡眠的儿童比例显著更高（P = 0.015）。咪达唑仑组更多儿童在最初8小时内表现出易怒（P = 0.07）。两组在疼痛、发热、呕吐、在车内睡觉、打鼾和唤醒困难的发生率方面没有统计学差异。口服镇静药物的持续影响可导致儿童从牙科诊所出院后出现长时间睡眠、易怒和呕吐。这些事件大多发生在最初8小时内，但在一些儿童中，影响可持续至24小时后。
