The author compared the effect of three kinds of medication for management of the uncooperative 45 children aged from 11 months to 5 year 5 months needing extensive treatment. Fifteen patients were given a dose of 75 ㎎/㎏ of chloral hydrate recatally(groupⅠ). Fifteen patients received the same dose of chloral hydrate rectally in combination with 20 mg of hydroxyzine orally(group Ⅱ). The remaining 15 patients were given the same dose of chloral hydrate rectally in combination with 3 ~ 4 mg of diazepam intramuscularly(group Ⅲ).
According to rating scale, sleep, crying, movement and overall behavior were checked for evaluation of the clinical sedative effect. Vital signs were also measured for assessing the safety of the patients and early detection of respiratory difficulties.
The results were as follows :
1. In the evaluation of sleep before and after dental treatment, rating scale of chloral hydrate and diazepam was superior to the other drugs.
2. In the evaluation of crying and movement during treatjment, rating scale of chloral hydrate and diazepam was superior to the other drugs and mean rating of each group was significantly different from the other group.
3. In the evaluation of overall behavior after dental treatment, 80% children of the chloral hydrate and diazepam were rated good or very good. With the chloral hydrate and hydroxuzine group and chloral hydrate group, 67% and 47% were rated good or very good respectively.
4. Heart rate, blood pressure and respiration rate remained unchanged during procedure. None of three groups monitored produced any significant respiratory depression or airway obstruction except statiscally oxygen saturation value depression only for subjects receiving chloral hydrate and diazepam compared with chloral hydrate.
Combined drug regimen was superior to single regimen, and the clinical effect of diazepam 3 ~ 4 ㎎ intramuscularly was superior to hydroxyzine 20 ㎎ orally. But further researches with the modified dosage and route will be needed to guide the most effective result for sedation.
|