A Retrospective Study of 248 Pediatric Oral Sedations Utilizing the Combination of Meperidine and Hydroxyzine for Dental Treatment

Abstract

Oral sedation for pre-cooperative and anxious pediatric patients is an important tool for the pediatric dentist. Few studies have examined the sedation regimen of meperidine and hydroxyzine.

Objectives: The primary goal of this study was to evaluate the overall safety and effectiveness of the meperidine/hydroxyzine drug combination. Secondary goals included detecting potential factors that alter sedation effectiveness.

Study design: Two hundred and forty eight electronic health records of pediatric patients (131 females, 117 males) who received meperidine/hydroxyzine sedations in a university setting were evaluated. Pediatric dental residents rated each case according to the Frankl behavioral scale and for effectiveness. Numerous factors were analyzed to evaluate their significance on overall effectiveness. Factors examined included age at time of treatment, gender, ASA status, Frankl score at various points during treatment, sextant of treatment, operator experience, dosage, use of nitrous oxide, and any complications encountered during treatment, both major and minor.

Results: Over 81% of sedations were considered effective or very effective. Statistically significant findings included age of patient, pre-sedation behavior, and willingness to take the medication. Less than 5% of sedations were aborted due to behavior. Only one major complication was found, which was not related to the sedation.

Conclusions: Meperidine combined with hydroxyzine is a safe and effective sedation regimen for uncooperative or pre-cooperative children during dental treatment.

Keywords: Conscious sedation; hydroxyzine; meperidine; pediatric dentistry.