COMPARING THE SEDATIVE EFFECT OF ORAL MIDAZOLAM/HYDROXYZINE VS. CHLORAL HYDRATE/HYDROXIZINE IN CHILDREN

Methods:  A total of 16 Children aged from 4-6 years were selected from those referred to Pedodontic Clinic at Shahid Beheshti University of Medical Sciences due to uncooperativeness. Cases with an anxiety score of 2 in Frankl scoring system were included with at least two similar dental needs with each case acting as self control. Informed consent was obtained from the parents in all cases. Each patient was assigned randomly to receive one of the two regimens first, while some received the other first. Dental behavior was videotaped using a mounted digital video recorder for all cases in each appointment.  Child’s reactions were scored using North Carolina Behavior Rating (NCBRS).  Patients received 1mg/kg Hydroxyzine and 0.5 mg/kg Midazolam in one visit and 50 mg/kg Chloral Hydrate along with 1mg/kg Hydroxyzine in the other visit. Attempts were made to keep the two treatment sections equal in all aspects including lesion size and timing.  Collected data were then tabulated and analyzed using Wilcoxon and Paired t-test.

Results: There was a clear increase in the level of child’s cooperation and behavior following use of these drugs. However there was no significant difference when reaction of children was compared after administration of the two cocktail drugs. There was a slight superiority in the use of Chloral hydrate/Hydroxyzine over that of Midazolam/Hydroxyzine combination (75% to 63% improved behavior).  Wilcoxon test showed no significant difference between effects of the two drug groups (P= 0.05).   

Conclusion: There were no significant differences between the two combination drugs; however Chloralhydrate/Hydroxyzine combination appears to have a higher sedative effect with a longer lasting period when compared to Midazolam/Hydroxyzine.

Keywords: Sedative effect, Midazolam/Hydroxazine, Chloral hydrate/Hydroxyzine, Child’s cooperation.