Anesth Prog. 2024 May 3;71(1):15-18. doi: 10.2344/22-00037.
The goal of this study was to compare the efficacy of midazolam/meperidine (M/M) vs midazolam/hydromorphone (M/H) for enteral moderate sedation along with inhalational sedation in pediatric dental patients.
This retrospective chart review analyzed the charts of pediatric patients who received dental treatment under enteral moderate sedation with either M/M or M/H in combination with inhalational sedation (nitrous oxide/oxygen) at El Rio Community Health Centers (affiliated with NYU Langone) in Tucson, Arizona, from July 2014 to December 2020. Included subjects were between 2 and 5 years of age, less than 20 kg, and otherwise healthy. In addition to demographic and drug-dosing data, treatment completion, sedation level, behavioral score, overall effectiveness, and sedation duration data were collected and analyzed from each patient's chart.
No statistically significant differences were observed when comparing the 2 drug regimens in treatment completion (P = .89), sedation level (P = .74), and overall effectiveness (P = .70). There was a statistically significant difference in behavior scoring, with the M/H group demonstrating higher scores (P = .04) than the M/M group.
The combination of midazolam and hydromorphone may provide an effective alternative to midazolam and meperidine when used with inhalational sedation (nitrous oxide/oxygen) for the moderate sedation of pediatric dental patients.
本研究旨在比较咪达唑仑/哌替啶（M/M）与咪达唑仑/氢吗啡酮（M/H）在儿科牙科患者肠内中度镇静联合吸入性镇静（氧化亚氮/氧气）中的疗效。
这项回顾性图表回顾分析了 2014 年 7 月至 2020 年 12 月期间在亚利桑那州图森市的埃尔里约社区健康中心（隶属于纽约大学朗格尼）接受肠内中度镇静联合吸入性镇静（氧化亚氮/氧气）的儿科患者的图表，这些患者接受 M/M 或 M/H 治疗。纳入的受试者年龄在 2 至 5 岁之间，体重小于 20 公斤，且身体其他方面健康。除了人口统计学和药物剂量数据外，还从每位患者的图表中收集和分析了治疗完成情况、镇静水平、行为评分、总体效果和镇静持续时间数据。
在比较两种药物方案的治疗完成情况（P =.89）、镇静水平（P =.74）和总体效果（P =.70）时，没有观察到统计学上的显著差异。在行为评分方面存在统计学上的显著差异，M/H 组的评分高于 M/M 组（P =.04）。
在儿科牙科患者的中度镇静中，与吸入性镇静（氧化亚氮/氧气）联合使用时，咪达唑仑和氢吗啡酮的组合可能是咪达唑仑和哌替啶的有效替代方案。
