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J Pediatr. 2012 May;160(5):807-13. doi: 10.1016/j.jpeds.2011.10.025. Epub 2011 Dec 1. Post-discharge adverse events following pediatric sedation with high doses of oral medication. - Costa LR, Costa PS, Brasileiro SV, Bendo CB, Viegas CM, Paiva SM.;   Faculty of Dentistry, Universidade Federal de Goiás, Goiânia, Brazil.

OBJECTIVE:    To compare the occurrence of post-discharge adverse events in children having received a high dose of either chloral hydrate (CH) or midazolam (MZ) during outpatient dental treatment.

STUDY DESIGN:  A repeated-measures study design was carried out with 42 children treated at a sedation center. The sample comprised 103 dental sedation sessions among 22 male and 20 female patients, 1-8 years old, receiving either MZ (1.0-1.5 mg/kg) or CH (70.0-100.0 mg/kg). During treatment, a single observer recorded intraoperative adverse events. Twenty-four hours later, the observer called the child's main caregiver seeking information on further adverse events. Data analysis involved descriptive and bivariate statistics and the general estimating equation for repeated measures.

RESULTS:   The most common intraoperative and post-discharge adverse events were hallucination (3.9%) and excessive sleep (41.9%), respectively. The chance of the occurrence of an adverse event following oral pediatric sedation was lesser among the children who received MZ than those who received CH (OR: 0.09; 95% CI: 0.01-0.88).

CONCLUSIONS:  High doses of CH were associated with post-discharge adverse events in children having undergone pediatric dental sedation, whereas high doses of MZ were not associated with these events in pediatric patients.

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PMID:  22133425