Alhaidari Roaa I, AlSarheed Maha A
Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
Children (Basel). 2022 Jan 22;9(2):142. doi: 10.3390/children9020142.
The aim of this study was to evaluate the post-discharge effects of oral midazolam with intranasal fentanyl sedation in pediatric patients who had dental treatment and to evaluate parents' preference regarding sedation visits.
A total of 32 uncooperative healthy pediatric patients aged 3-6 years old who met the inclusion criteria were included. In the first visit, one group received oral midazolam (0.7 mg/kg) with intranasal fentanyl (1 μg/kg) sedation (M/F) and the other group received oral midazolam with intranasal placebo (M), and in the second visit each group received the other type of sedation in a cross-over type. In this cross-sectional study, a post-discharge phone-call questionnaire was carried out 24 h after both sedation visits with the parents to evaluate the children's behavior, function, balance, eating pattern, sleeping pattern, vomiting incidents, and any possible side effects, as well as parents' satisfaction and preference. The Wilcoxon signed-rank test was used to analyze the categorical variables, and the Chi-square test was performed to analyze the parents' preference.
A total of 32 parents responded to the phone-call questionnaire after 64 sedation visits. All of them were mothers. There was no statistically significant difference between the two groups with respect to recovery to normal function and balance, behavior, incidents of fever, vomiting, sleep disturbance, oversleeping, and adverse behavioral changes ( > 0.05). Children required a significantly longer amount of time until the first meal after M/F sedation ( = 0.04). No significant difference was found between parents' preferences regarding the sedation visits ( > 0.05).
Intranasal fentanyl added to oral midazolam sedation could have an effect on post-discharge adverse behavioral changes, prolonged sleeping, and prolonged recovery time. Children sedated with midazolam/fentanyl required a longer amount of time until the first meal. Vomiting and fever occurred similarly in both sedation regimens with a low incidence. There was no difference in parents' preferences regarding the two sedation regimens.
本研究旨在评估口服咪达唑仑联合鼻内芬太尼镇静对接受牙科治疗的儿科患者出院后的影响，并评估家长对镇静就诊的偏好。
共纳入32名符合纳入标准的3 - 6岁不合作健康儿科患者。在第一次就诊时，一组接受口服咪达唑仑（0.7 mg/kg）联合鼻内芬太尼（1 μg/kg）镇静（M/F组），另一组接受口服咪达唑仑联合鼻内安慰剂（M组），在第二次就诊时，每组以交叉方式接受另一种类型的镇静。在这项横断面研究中，在两次镇静就诊后24小时对家长进行出院后电话问卷调查，以评估儿童的行为、功能、平衡、饮食模式、睡眠模式、呕吐事件以及任何可能的副作用，以及家长的满意度和偏好。采用Wilcoxon符号秩检验分析分类变量，采用卡方检验分析家长的偏好。
在64次镇静就诊后，共有32名家长回复了电话问卷。他们均为母亲。两组在恢复正常功能和平衡、行为、发热事件、呕吐、睡眠障碍、嗜睡以及不良行为变化方面无统计学显著差异（P>0.05）。M/F组镇静后儿童直到第一餐所需的时间显著更长（P = 0.04）。家长对镇静就诊的偏好之间未发现显著差异（P>0.05）。
口服咪达唑仑镇静中添加鼻内芬太尼可能对出院后的不良行为变化、睡眠延长和恢复时间延长有影响。接受咪达唑仑/芬太尼镇静的儿童直到第一餐所需的时间更长。两种镇静方案中呕吐和发热的发生率相似且较低。家长对两种镇静方案的偏好没有差异。
