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Comparison of oral midazolam with and without hydroxyzine in the sedation of pediatric dental patients.
Pediatr Dent. 2004 Nov-Dec; 26(6):492-6.PD

Abstract

PURPOSE

The purpose of this study was to compare the effectiveness of midazolam (MDZ) alone to a combination of MDZ and hydroxyzine (MDZH) when sedating young children for dental treatment.

METHODS

This was a prospective, double-blinded, crossover clinical study of young uncooperative children in need of at least 2 restorative visits. Twenty-eight children, ages 21 to 56 months, with a mean age of 36.6 months, participated in this study. The subjects were assigned randomly to receive either 0.5 mg/kg of oral MDZ 20 minutes prior to the beginning of dental treatment or the combination of 0.3 mg/kg oral MDZ with 3.7 mg/kg of hydroxyzine 30 minutes before treatment. The alternative drug regimen was administered at the second appointment. All subjects also received 50% nitrous oxide and were restrained with a papoose board. The child's behavior (quiet or crying, relaxed or moving) was evaluated every 5 minutes by an experienced pediatric dentist who was unaware of the drug given to the child. At the conclusion of treatment, each session was evaluated for overall effectiveness.

RESULTS

Regardless of the type of premedication, more patients exhibited quiet behavior at the beginning of treatment, with an increase in crying and movement toward the end of treatment. Regarding movement, a significant difference was observed during the first 20 minutes between the 2 regimens. MDZ showed more children exhibiting movement. During the first 30 minutes of treatment, more children cried in the MDZ group, while MDZH presented more children asleep or quiet. No significant differences were found in behavior as a function of the order the sedative regimens were given. No significant differences between the 2 regimens regarding overall behavior and success (t=0.655 at 27 degrees of freedom; P=.518) were found.

CONCLUSIONS

The combination of hydroxyzine (3.7 mg/kg) with MDZ (0.3 mg/kg) administered 30 minutes before treatment resulted in safe and effective sedation for the dental treatment of young children. This combination's use might be more advantageous when compared to MDZ alone, resulting in less crying and movement during the first 30 and 20 minutes, respectively.

Authors+Show Affiliations

Department of Pediatric Dentistry, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15646910

Citation

Shapira, Joseph, et al. "Comparison of Oral Midazolam With and Without Hydroxyzine in the Sedation of Pediatric Dental Patients." Pediatric Dentistry, vol. 26, no. 6, 2004, pp. 492-6.
Shapira J, Kupietzky A, Kadari A, et al. Comparison of oral midazolam with and without hydroxyzine in the sedation of pediatric dental patients. Pediatr Dent. 2004;26(6):492-6.
Shapira, J., Kupietzky, A., Kadari, A., Fuks, A. B., & Holan, G. (2004). Comparison of oral midazolam with and without hydroxyzine in the sedation of pediatric dental patients. Pediatric Dentistry, 26(6), 492-6.
Shapira J, et al. Comparison of Oral Midazolam With and Without Hydroxyzine in the Sedation of Pediatric Dental Patients. Pediatr Dent. 2004 Nov-Dec;26(6):492-6. PubMed PMID: 15646910.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of oral midazolam with and without hydroxyzine in the sedation of pediatric dental patients. AU - Shapira,Joseph, AU - Kupietzky,Ari, AU - Kadari,Avishag, AU - Fuks,Anna B, AU - Holan,Gideon, PY - 2005/1/14/pubmed PY - 2005/2/12/medline PY - 2005/1/14/entrez SP - 492 EP - 6 JF - Pediatric dentistry JO - Pediatr Dent VL - 26 IS - 6 N2 - PURPOSE: The purpose of this study was to compare the effectiveness of midazolam (MDZ) alone to a combination of MDZ and hydroxyzine (MDZH) when sedating young children for dental treatment. METHODS: This was a prospective, double-blinded, crossover clinical study of young uncooperative children in need of at least 2 restorative visits. Twenty-eight children, ages 21 to 56 months, with a mean age of 36.6 months, participated in this study. The subjects were assigned randomly to receive either 0.5 mg/kg of oral MDZ 20 minutes prior to the beginning of dental treatment or the combination of 0.3 mg/kg oral MDZ with 3.7 mg/kg of hydroxyzine 30 minutes before treatment. The alternative drug regimen was administered at the second appointment. All subjects also received 50% nitrous oxide and were restrained with a papoose board. The child's behavior (quiet or crying, relaxed or moving) was evaluated every 5 minutes by an experienced pediatric dentist who was unaware of the drug given to the child. At the conclusion of treatment, each session was evaluated for overall effectiveness. RESULTS: Regardless of the type of premedication, more patients exhibited quiet behavior at the beginning of treatment, with an increase in crying and movement toward the end of treatment. Regarding movement, a significant difference was observed during the first 20 minutes between the 2 regimens. MDZ showed more children exhibiting movement. During the first 30 minutes of treatment, more children cried in the MDZ group, while MDZH presented more children asleep or quiet. No significant differences were found in behavior as a function of the order the sedative regimens were given. No significant differences between the 2 regimens regarding overall behavior and success (t=0.655 at 27 degrees of freedom; P=.518) were found. CONCLUSIONS: The combination of hydroxyzine (3.7 mg/kg) with MDZ (0.3 mg/kg) administered 30 minutes before treatment resulted in safe and effective sedation for the dental treatment of young children. This combination's use might be more advantageous when compared to MDZ alone, resulting in less crying and movement during the first 30 and 20 minutes, respectively. SN - 0164-1263 UR - https://www.unboundmedicine.com/medline/citation/15646910/Comparison_of_oral_midazolam_with_and_without_hydroxyzine_in_the_sedation_of_pediatric_dental_patients_ L2 - https://www.ingentaconnect.com/openurl?genre=article&issn=0164-1263&volume=26&issue=6&spage=492&aulast=Shapira DB - PRIME DP - Unbound Medicine ER -