Efficacy of Midazolam/Meperidine vs Midazolam/Hydromorphone for Enteral Moderate Sedation in the Pediatric Dental Patient

Objective: The goal of this study was to compare the efficacy of midazolam/meperidine (M/M) vs midazolam/hydromorphone (M/H) for enteral moderate sedation along with inhalational sedation in pediatric dental patients. Methods: This retrospective chart review analyzed the charts of pediatric patients who received dental treatment under enteral moderate sedation with either M/M or M/H in combination with inhalational sedation (nitrous oxide/oxygen) at El Rio Community Health Centers (affiliated with NYU Langone) in Tucson, Arizona, from July 2014 to December 2020. Included subjects were between 2 and 5 years of age, less than 20 kg, and otherwise healthy. In addition to demographic and drug-dosing data, treatment completion, sedation level, behavioral score, overall effectiveness, and sedation duration data were collected and analyzed from each patient’s chart. Results: No statistically significant differences were observed when comparing the 2 drug regimens in treatment completion ( P = .89), sedation level ( P = .74), and overall effectiveness ( P = .70). There was a statistically significant difference in behavior scoring, with the M/H group demonstrating higher scores ( P = .04) than the M/M group. Conclusion: The combination of midazolam and hydromorphone may provide an effective alternative to midazolam and meperidine when used with inhalational sedation (nitrous oxide/oxygen) for the moderate sedation of pediatric dental patients.