Comparison of the Effect of Oral Chloral hydrate and Chloral hydrate-Hydroxyzine on Sedation of Non-cooperative Children During Dental Treatment

Abstract

Statement of Problem: Dental treatment for anxious children is a great challenge for dentists. Pharmacologic techniques may lead to dental treatments with better safety and quality.Purpose: The purpose of this study was to compare the sedative effect of chloral hydrate alone with chloral hydrate-hydroxyzine regimen in dental treatment of very anxious 3-5 year-old children.Materials and Method: This study was a blind randomized cross-over trial. Each individual had his/her own control within each protocol. Furthermore, the two protocols were compared. Twenty children, who exhibited "definitely negative behavior" according to the Frankl scale, were assigned to receive oral chloral hydrate (45 mg/kg) for one session or a combination of chloral hydrate (40 mg/kg) and hydroxyzine (1.5 mg/kg) for the other session. The children's behavior during the treatment was observed and ranked by a blind examiner, based on NCBRS method. Also, the qualitative success rate was determined by Houpt rating scale for the overall behavior. The data were analyzed, using SPSS software and MANOVA test.Results: Children in both treatment sessions presented better scores for behavior than those in the first session ( p <0.001). Based on the present findings, the following negative behaviors were significantly reduced in pharmacotherapy sessions: high hand ( p =0.041), crying ( p <0.001), verbal protest ( p =0.027) and oral resistance ( p <0.001). There was no statistically significant difference between the effect of the two pharmacologic regimens during treatment sessions ( p >0.05).Conclusion: Oral chloral hydrate) 45 mg/kg) is recommended as a sedative agent for dental treatment of very anxious children as compared to the combination of chloral hydrate with hydroxyzine.Key words: Chloral hydrate, Hydroxyzine, Conscious sedation