Comparison of Two Morphine-Benzodiazepine-Hydroxyzine Combinations for the Oral Sedation of Pediatric Dental Patients: A Retrospective Study

Purpose: To investigate the effectiveness of oral morphine sulfate regimens in sedating pediatric dental patients and assess whether pre-sedation disposition and willingness to take the sedative were related to the outcome of the sedation. Methods: The sedation records of 271 pediatric dental patients sedated with oral morphine were reviewed. Children were either sedated with regimen one (morphine plus midazolam plus hydroxyzine) or regimen two (morphine plus diazepam plus hydroxyzine). Data gathered included the patient's pre-sedation disposition, willingness to take the sedative, effectiveness of sedation, and occurrence of any adverse event. Data analysis was conducted using descriptive statistics, Pearson's chi-square, and logistic regression. Results: Regimens one and two had an overall success rate of 80 percent (143 out of 178) and 81 percent (75 out of 93), respectively. A positive correlation was observed between the patient's willingness to take his/her sedative medication and the effectiveness of the sedation using both the Pearson's chi-square (P=.004) and logistic regression (P=.028). Adverse events occurred in six percent (17 out of 271) of the cases. Conclusions: Overall rate of effective sedation using various oral morphine sulfate regimens was above 80 percent. Minimal adverse events occurred. The patient's willingness to take the sedative was positively associated with the outcome of the sedation regimen.