title: Postdischarge events occurring after pediatric sedation for dentistry.
abstract: OBJECTIVE
  To investigate postdischarge events occurring in children during the 24 hours following sedation for dentistry.
  
  
  METHODS
  A convenience sample of 50 children undergoing sedation with combinations of midazolam, hydroxyzine, and meperidine were included. Parents received a standardized timesheet to record child's behavior, alertness, activity level, motor imbalance, emesis, and soft tissue trauma every two hours from discharge until bedtime. A questionnaire asked about transportation, supervision, and return to normal activity. Families were telephoned after 24 hours to collect the information.
  
  
  RESULTS
  Sixty-six percent of children slept in the car; of these, 30 percent were supervised by only the driver, and 12 percent were difficult to awaken. Agitation was observed in 22 percent, restlessness in 10 percent, withdrawn behavior in 16 percent, and soft tissue trauma in 18 percent. Motor imbalance was significantly associated with midazolam (P=.002), as was restlessness (P=.004). Eighty-two percent slept between discharge and bedtime, with 16 percent sleeping for greater than four hours. Return to normal activity was greater than four hours in 36 percent, and was inversely correlated with age (P=.02).
  
  
  CONCLUSIONS
  Postdischarge sleepiness, drug-specific motor imbalance, sleep during transit, and recovery times greater than four hours were common and warrant vigilant adult supervision.
authors.affiliation: Clinical assistant professors, Department of Pediatric Dentistry, in the School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Fehmida Z
authors.initials: FZ
authors.lastname: Dosani
authors.affiliation: Department of Diagnostic and Biomedical Sciences, Department of Pediatric Dentistry, in the School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA;Department of Pediatric Dentistry, in the School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Flaitz
authors.affiliation: Department of Oral and Maxillofacial Surgery, in the School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA.
authors.forename: H Clark
authors.initials: HC
authors.lastname: Whitmire
authors.affiliation: Department of Pediatric Dentistry, in the School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Vance
authors.affiliation: Department of pediatric dentistry, West Virginia University, Morgantown, W.V., USA. fehmida.z.dosani@uth.tmc.edu.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Hill
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017109:Akathisia, Drug-Induced / Q000209:etiology; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental / Q000009:adverse effects*; D001364:Awareness / Q000187:drug effects; D001734:Bites, Human / Q000209:etiology; D002648:Child; D002652:Child Behavior / Q000187:drug effects*; D002675:Child, Preschool; D016292:Procedural Sedation / Q000009:adverse effects*; D004409:Dyskinesia, Drug-Induced / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006919:Hydroxyzine / Q000008:administration & dosage / Q000009:adverse effects; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008614:Meperidine / Q000008:administration & dosage / Q000009:adverse effects; D008874:Midazolam / Q000008:administration & dosage / Q000009:adverse effects; D009043:Motor Activity / Q000187:drug effects; D009061:Mouth Mucosa / Q000293:injuries; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000209:etiology; D012890:Sleep / Q000187:drug effects; D012894:Sleep Stages / Q000187:drug effects; D014839:Vomiting / Q000209:etiology
chemical_list: D006993:Hypnotics and Sedatives; D006919:Hydroxyzine; D008614:Meperidine; D008874:Midazolam