title: Oral Sedation Postdischarge Adverse Events in Pediatric Dental Patients.
abstract: The study investigated patient discharge parameters and postdischarge adverse events after discharge among children who received oral conscious sedation for dental treatment. This prospective study involved 51 patients needing dental treatment under oral conscious sedation. Each patient received one of various regimens involving combinations of a narcotic (ie, morphine or meperidine), a sedative-hypnotic (ie, chloral hydrate), a benzodiazepine (ie, midazolam or diazepam), and/or an antihistamine (ie, hydroxyzine HCl). Nitrous oxide and local anesthesia were used in conjunction with all regimens. After written informed consent was obtained, each guardian was contacted by phone with specific questions in regard to adverse events following the dental appointment. Out of 51 sedation visits, 46 were utilized for analysis including 23 boys and 23 girls ranging from 2 years 2 months to 10 years old (mean 5.8 years). 60.1% of patients slept in the car on the way home, while 21.4% of that group was difficult to awaken upon reaching home. At home, 76.1% of patients slept; furthermore, 85.7% of patients who napped following the dental visit slept longer than usual. After the appointment, 19.6% exhibited nausea, 10.1% vomited, and 7.0% experienced a fever. A return to normal behavior was reported as follows: 17.4% in <2 hours, 39.1% in 2-6 hours, 28.3% in 6-10 hours, and 15.2% in >10 hours. Postdischarge excessive somnolence, nausea, and emesis were frequent complications. The time to normality ranged until the following morning demonstrating the importance of careful postdischarge adult supervision.
authors.affiliation: Assistant Professor of Clinical Dentistry in Pediatric Dentistry, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California.
authors.forename: Annie
authors.initials: A
authors.lastname: Huang
authors.affiliation: Graduate Clinic Director of Pediatric Dentistry, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California.
authors.forename: Thomas
authors.initials: T
authors.lastname: Tanbonliong
mesh_terms: D000284:Administration, Oral; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D000766:Anesthesia, Dental / Q000009:adverse effects*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D002648:Child; D002652:Child Behavior / Q000187:drug effects; D002675:Child, Preschool; D002697:Chloral Hydrate / Q000008:administration & dosage / Q000009:adverse effects; D016292:Procedural Sedation / Q000009:adverse effects*; D003975:Diazepam / Q000008:administration & dosage / Q000009:adverse effects; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006634:Histamine H1 Antagonists / Q000008:administration & dosage / Q000009:adverse effects; 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; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects; D009325:Nausea / Q000209:etiology; D009609:Nitrous Oxide / Q000008:administration & dosage; D011446:Prospective Studies; D012890:Sleep / Q000187:drug effects; D014839:Vomiting / Q000209:etiology
chemical_list: D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D004338:Drug Combinations; D006634:Histamine H1 Antagonists; D006993:Hypnotics and Sedatives; D006919:Hydroxyzine; D002697:Chloral Hydrate; D009020:Morphine; D008614:Meperidine; D009609:Nitrous Oxide; D003975:Diazepam; D008874:Midazolam
keywords: Chloral hydrate; Conscious sedation; Dental treatment; Diazepam; Hydroxyzine; Meperidine; Midazolam; Morphine; Postdischarge adverse event