Comparison of the efficacy of oral midazolam alone versus midazolam and meperidine in the pediatric dental patient

PURPOSE: The purpose of this study was to compare midazolam alone (Group A: 1 mg/kg) vs midazolam plus meperidine (Group B: 0.5 and 1 mg/kg, respectively) in regard to physiology and behavior of young children sedated for dental restorative care. METHODS: Twenty healthy children who met selection criteria were randomly assigned to 1 of 2 groups and subsequently treated in a prospective, crossover design. All sedative agents were administered orally, and all sedations included 50% nitrous oxide administered via a nasal hood. Heart rate, systolic and diastolic blood pressure, and behavior were recorded at 8 procedural or time periods during the visits. Chi-square and ANOVA were used to analyze the data. RESULTS: No difference in physiology or behavior was found between groups. However, higher heart rates and disruptive behaviors occurred more frequently during or after local anesthesia administration. CONCLUSIONS: Oral midazolam alone is just as effective as midazolam with meperidine. Disruptive behaviors accounted for increased heart rates.