Retrospective Evaluation of Moderate Sedation Visits That Used Oral Meperidine and Hydroxyzine With Oral or Intranasal Midazolam.

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE
JOURNAL OF DENTISTRY FOR CHILDREN Pub Date : 2023-11-15
Gaurav Jain, Ronald Curran, Robert S Jones
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引用次数: 0

Abstract

Purpose: To examine the influence of substituting intranasal (IN) midazolam (MID) for oral (PO) MID, within the three-drug combination of meperidine (MEP), hydroxyzine (H) and MID, on sedation treatment outcomes. Methods: A retrospective, cross-sectional analysis examined patient variables and sedation outcomes in 508 pediatric dental patients sedated by single- and multi-drug sedation regimens (MEP-H; MEP-H-(PO)-MID; MEP-H-(IN)-MID; single-agent MID). The outcome assessment examined sedation visit effectiveness, sedation treatment completion, treatment time and medication administration to discharge time. Multivariable logistic regression analyses assessed predictive variables associated with sedation visit effectiveness. Results: Both three-drug combinations (MEP-H-(PO)-MID; MEP-H-(IN)-MID) were used for behavior guidance in children of a similar age (median age=7.1 and 6.5 years, respectively, for the two drug combinations) and weight (median weight = 23.7 and 23.5 kg, respectively, for the two drug combinations). These three-drug combinations had a higher likelihood of sedation effectiveness over the reference sedation regimen of single-agent midazolam (MEP-H-(PO)-MID adjusted odds ratio [OR] = 2.65; 95 percent confidence interval [95% CI]=1.09 to 6.45; P=0.032; and MEP-H-(IN)-MID OR=2.08; 95% CI=1.03 to 4.18; P=0.039). MEP-H-(IN)MID was associated with a shorter medication administration to discharge time for patients by 23 minutes (interquartile range [IQR]=9.5 to 34 minutes) compared to MEP-H-(PO) MID (P<0.05) while providing a comparable number of teeth treated (median=five). All sedation drug regimens, including MEP-H-(IN)MID, had high levels of oxygen saturation during all sedation appointments. Conclusion: Substituting IN for PO MID in MEP-H-MID was associated with a shorter total time to discharge while demonstrating comparable efficacy during sedation.

对使用口服美哌啶和羟嗪以及口服或鼻内咪达唑仑的中度镇静疗程进行回顾性评估。
目的:研究在甲哌啶(MEP)、羟嗪(H)和咪达唑仑(MID)的三药组合中,用鼻内(IN)咪达唑仑(MID)替代口服(PO)咪达唑仑(MID)对镇静治疗效果的影响。研究方法回顾性横断面分析研究了508名儿童牙科患者在使用单药和多药镇静方案(MEP-H;MEP-H-(PO)-MID;MEP-H-(IN)-MID;单药MID)镇静治疗后的患者变量和镇静效果。结果评估检查了镇静就诊效果、镇静治疗完成度、治疗时间和用药至出院时间。多变量逻辑回归分析评估了与镇静疗效相关的预测变量。结果:在年龄(两种药物组合的中位年龄分别为 7.1 岁和 6.5 岁)和体重(两种药物组合的中位体重分别为 23.7 公斤和 23.5 公斤)相似的儿童中,均使用了三种药物组合(MEP-H-(PO)-MID;MEP-H-(IN)-MID)进行行为指导。与单剂咪达唑仑的参考镇静方案相比,这三种药物组合具有更高的镇静效果(MEP-H-(PO)-MID调整后的比值比[OR]=2.65;95%置信区间[95% CI]=1.09至6.45;P=0.032;MEP-H-(IN)-MID OR=2.08;95% CI=1.03至4.18;P=0.039)。与MEP-H-(PO) MID相比,MEP-H-(IN)MID可使患者从用药到出院的时间缩短23分钟(四分位数间距[IQR]=9.5至34分钟)(结论:MEP-H-(IN)MID可使患者从用药到出院的时间缩短23分钟(四分位数间距[IQR]=9.5至34分钟):在 MEP-H-MID 中,用 IN 取代 PO MID 可缩短患者从用药到出院的总时间,同时在镇静过程中显示出相似的疗效。
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来源期刊
JOURNAL OF DENTISTRY FOR CHILDREN
JOURNAL OF DENTISTRY FOR CHILDREN DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
1.00
自引率
0.00%
发文量
19
期刊介绍: Acquired after the merger between the American Society of Dentistry for Children and the American Academy of Pediatric Dentistry in 2002, the Journal of Dentistry for Children (JDC) is an internationally renowned journal whose publishing dates back to 1934. Published three times a year, JDC promotes the practice, education and research specifically related to the specialty of pediatric dentistry. It covers a wide range of topics related to the clinical care of children, from clinical techniques of daily importance to the practitioner, to studies on child behavior and growth and development. JDC also provides information on the physical, psychological and emotional conditions of children as they relate to and affect their dental health.
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