Evaluation of an alphaprodine-hydroxyzine combination as a sedative agent in the treatment of the pediatric dental patient.
This investigation proposed and evaluated a submucosally administered standard dose drug combination containing .6 mgm/kgm alphaprodine hydrochloride and .3 mgm/kgm hydroxyzine hydrochloride, in conjunction with nitrous oxide, oxygen, and lidocaine with epinephrine, in the sedation and treatment of uncooperative pediatric dental patients. Observations from this study include: The technique was successful in attaining a desirable, conscious sedation level that was characterized by rapid onset, maintenance throughout treatment, and rapid reversibility with naloxone and 100% oxygen. The protective airway reflexes remained intact during the procedures. Vital signs remained fairly constant throughout the treatment. Respiratory rate was slightly depressed during the sedation, but hemoglobin oxygen saturation levels remained constant. There were no incidences of respiratory depression, hypoxia, or apnea either during or after treatment, and no emergency medical or resuscitative efforts were necessary. Twenty-four hours after the appointment, few patients complained of the experience and more than half stated that they looked forward to returning. In view of these findings, the techniques and drug combination described in this investigation appear to provide a safe and effective means for the sedation and treatment of uncooperative pediatric dental patients. It should be emphasized, however, that the dentist using these methods should have a thorough knowledge of the agents involved, the ability to monitor patients and recognize possible adverse reactions, and the capacity to respond to any emergency situations should they arise. Consequently, only practitioners who have had extensive training and experience in all forms of anesthesia, especially pediatric anesthesia, should consider the use of these agents in their practices. It should be emphasized further that the agents and techniques should be used only for conscious sedation, the light level of sedation during which the patient retains the ability present before sedation to independently maintain an airway and respond appropriately to verbal command, and not for any deeper forms of anesthesia.
D000522:Alphaprodine / Q000008:administration & dosage*; D000766:Anesthesia, Dental; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003299:Cooperative Behavior; D003729:Dental Care / Q000523:psychology*; D004359:Drug Therapy, Combination; D004837:Epinephrine; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006919:Hydroxyzine / Q000008:administration & dosage*; D008012:Lidocaine; D008297:Male; D009609:Nitrous Oxide; D011229:Preanesthetic Medication; D013997:Time Factors
D000522:Alphaprodine; D006919:Hydroxyzine; D008012:Lidocaine; D009609:Nitrous Oxide; D004837:Epinephrine