Oral Midazolam with and without meperidine for management of the difficult young perdiatric dental patient: a retrospective study
John E. Nathan, DDS, MDS
Kaaren G. Vargas, DDS, PhD
Resident: Avani Khera
Purpose: To examine the effectiveness of different dosages of midazolam used with or without meperidine to manage the difficult pediatric dental patient.
Methods: 120 patient records with sedation logs were reviewed. The subjects were divided into six groups based on dosages of midazolam alone or in combination with meperidine. Ratings of the effectiveness of sedation, duration of action, need for restraint to accomplish treatment, and recovery times were made.
Higher doses of midazolam alone can produce better results in the severely apprehensive patient.
Children below the age of reason may require deeper levels of consciousness to permit invasive procedures
The addition of meperidine (1.0 mg/kg) doubled efficacy with 80% visits showing adequate or better ratings. In addition it also doubled working time from 8 to 18 minutes.
Higher doses of meperidine (1.0 mg/kg) did not show better results and warranted safety concerns for patients who were over sedated.
Conclusions: The addition of meperidine appears to enhance the effectiveness and duration of action of midazolam for managing difficult young pediatric patients.