The effect of metoclopramide and hydroxyzine in sedation of infants undergoing dental treatment.

The purpose of the present study was to determine whether the administration of 5 mg of the anti-emetic drug metoclopramide (MTP) would improve the effectiveness of 3.7 mg/kg of hydroxyzine (HYZ) in dental treatment of young patients. Thirty uncooperative children, with a mean age of twenty-nine months, and needing at least two restorative visits, participated in this study. The patients were assigned randomly to receive either 3.7 mg/kg HYZ or the same drug in conjunction with MTP; alternate regimens were administered at the two appointments. All the children received 50 percent nitrous oxide, and were restrained in a Papoose Board with a head holder. The following parameters were evaluated at baseline (before initiation of treatment), and at five-minute intervals throughout the procedure: degree of alertness, crying and movement. Evaluation of the overall behavior at each session was performed by one investigator, who was blind to the drug regimen the child had received, utilizing a separate rating scale. The results were submitted to statistical analysis. No differences were observed in the behavior of the children receiving both regimens. Successful sedation, as assessed by lack or minimal crying and/or movement was observed in all the treatment visits, with both regimens (mean score 4.4 for HYZ + MTP and 4.6 for HYZ). In the few occasions, however, where the restorative sessions were longer (45 to 60 minutes), more children fell asleep after receiving protocol A (pramin + hydroxyzine), suggesting a possible trend to improve effectiveness in these situations. No adverse effects were observed, and all the treatments were successfully completed. Although no significant differences could be observed in treatments lasting up to a half hour, the addition of MTP could help in sedations lasting longer than a half hour.