Diazepam, Meperidine, and Hydroxyzine as a Moderate Sedation Regimen in Pediatric Dentistry: A Retrospective Study.

Background: Moderate sedation is a behavior guidance technique in pediatric dentistry, and evaluating existing regimens can improve sedation outcomes and safety.

Aim: To determine if behavior at consult and sedation medication dosages is associated with sedation success and the patient's behavior using diazepam, meperidine, and hydroxyzine (DMH) regimen.

Design: A retrospective chart review of 324 patients who underwent 404 oral moderate sedations with (DMH) from April 2017 to June 2022. Sedations were graded as Successful or Unsuccessful and Positive (Frankl F3 or F4) or Negative (Frankl F1 or F2) behavior. Primary variables included Frankl behavior at consult and medication dosages. Logistic regression models were used to determine if these factors were associated with sedation success and behavior while adjusting for other patient and sedation characteristics.

Results: DMH yielded mostly successful sedations (89%) and Positive Behavior (Frankl F3 or F4) (72%). Lower Frankl scores at consult (OR: 2.3, p = 0.0140) were associated with increased odds of sedation failure. Increased age (OR: 0.8, p = 0.0047) was associated with decreased odds of failure. Meperidine dose demonstrated a significant association with improved sedation while controlling for age and behavior (p < 0.0001).

Conclusion: The (DMH) is an effective moderate sedation regimen. Patient selection is a significant factor in sedation success.