Effect of moderate sedation regimen (diazepam, meperidine, and hydroxyzine) dosages on patient behavior and outcome of sedation in Pediatric Dentistry: a retrospective study

Purpose: To determine if behavior at consult visit and sedation medication dosages are associated with the success of sedation visits and patient’s behavior using the diazepam, meperidine, and hydroxyzine (DMH) regimen. Methods: A retrospective chart review was conducted of 324 VCU Pediatric Dentistry Department patients who underwent 404 moderate conscious sedation visits with DMH regimen from April 2017 to June 2022. Sedation visits were graded as “Successful” or “Unsuccessful” and “Good” or “Poor behavior.” The primary variables of interest included Frankl behavior at consult visit and the sedation medication dosages. Logistic regression models were used to determine if these factors were associated with sedation success and overall sedation behavior while adjusting for other patient and sedation characteristics. Results: The regimen yielded mostly successful sedations (89%) and “Good Sedation Behavior” (Frankl 3 and 4) (72%). Lower Frankl scores at consult visits (OR: 2.3, P=0.0140) were associated with increased odds of failure. Increased age (OR: 0.8, P=0.0047) was associated with decreased odds of sedation failure. Meperidine dose demonstrated trends towards significant association with potential for clinical relevance. Conclusion: This study shows that the diazepam, meperidine, and hydroxyzine (DMH) regimen is an effective moderate sedation regimen. Patient selection is a significant factor in the success of the DMH moderate sedation