Journal of the American Dental Association, Vol 109, Issue 4, 564-569
Copyright © 1984 by American Dental Association
Sedation in pediatric dentistry: a practical assessment procedure
PA Moore,
EA Mickey,
JA Hargreaves,
and
HL Needleman
An assessment model for evaluating sedation in pediatric dental patients has been described. The model in whole or in part can be a valuable asset in drug trials and clinical evaluations. The unique characteristics of this model include: assessments are easily and quickly carried out without interruption of normal patient care; the criteria for sedation behavior can be standardized and are clinically relevant; a determination of the level of consciousness using an airway obstruction maneuver permits an assessment of safety; and the reliability of the observer ratings is extremely high, thereby avoiding the necessity of specially trained personnel. Using the assessment procedure, a placebo-controlled, double-blind clinical trial of various doses of chloral hydrate with and without N2O was performed. The results indicate that: children receiving the placebo treatment behaved favorably for at least 46% of the ratings; the 20 mg/kg and 40 mg/kg chloral hydrate groups showed little or no improvement when compared with the placebo group; the group receiving 60 mg/kg chloral hydrate had as much as a 33% improvement in behavior as compared with placebo; and with the addition of 40% N2O/60% O2 to 60 mg/kg chloral hydrate premedication, four of 15 children (27%) were unable to maintain a patent airway when intentionally obstructed.