366 - Pediatric Dental Post-Sedation Discharge Events and Proper Discharge Timing

Purpose: The aim of this study was to validate discharge scales, the Modified Aldrete Score (MAS) and the Vancouver Recovery Score (VRS) in pediatric sedation and to compare the post-discharge effects of commonly used moderate sedation medicaments in pediatric dentistry.

Methods: This prospective study recruited patients 6 years or younger, receiving dental treatment under moderate sedation at Bon Secours Pediatric Dental Associates (BSPDA). The children received one of the following drug regimens, combined with nitrous oxide: 1) PO midazolam, 2) PO midazolam/PO hydroxyzine, 3) IN dexmedetomidine, 4) IN dexmedetomidine/PO midazolam, 5) IN Midazolam, or 6) PO Triazolam. The patients were scored using the MAS and VRS pre-operatively and post-operatively for 20 minutes by both a sedation nurse and observing resident. A short parent survey about the patient’s behavior and recovery after leaving the office was collected.

Results: A total of 70 patients were recruited in this study. The mean age was 5.3 years old with 57% male and 43% female.  The resident’s and nurses VRS scores post-op agreed 73% of the time and the MAS score agreed 97% of the time.  The parent surveys found 48% of children fell asleep on the ride home, 42% were agitated after home, 58% were less active after returning home, and 38% returned to normal activity 2-4 hours after returning home.

Conclusion: Based on this study’s current data, VRS and MAS are global scales to use for discharge criteria with moderate sedation. Survey data indicates behavior post-sedation at home may be altered.

Identify Supporting Agency and Grant Number: Research supported by Bon Secours St. Mary's Hospital of Richmond