Indiana University-Purdue University Indianapolis (IUPUI) / Treating pediatric dental patients four years old and younger can be difficult at
times due to patient behavior. Conscious sedation has been employed as a means to
control pediatric dental patients for several years. Butorphanol tartrate has been used
safely for pain control in pediatric patients for several years, but has never been used for
sedating pediatric dental patients. The purpose of this study is to compare the behavioral
and physiologic effects of conscious sedation on pediatric dental patients using
intramuscular meperidine and an equipotent dosage of intramuscular butorphanol. Forty
conscious sedations of ASA I pediatric dental patients between the ages of 13 and 60
months were accomplished using either 2.0 mg/kg of intramuscular meperidine or 0.03
mg/kg of intramuscular butorphanol. Each sedation was videotaped and three viewers
viewed the videotapes rating them with a computer program (ACS) involving a four-code
behavior rating scale. The tlrree viewers rated patient behavior for each sedation also
with a form with global rating, categorical, and dichotomous scales. Physiologic signs of
oxygen saturation, blood pressure, heart rate, and respiration rate were monitored at
baseline and every 5 minutes during treatment. The operator also rated the sedation
patient behavior with a form that had pre-treatment Frankl, post-treatment Frankl, global
rating categorical, dichotomous, and sedation success rating scales. The two groups
demographic data, physiologic data, ACS data, the three viewer's behavior rating form,
and the operator's behavior rating form were analyzed for any statistically significant
differences between the groups. The statistical analysis of the demographic data revealed
a statistically significant trend in the butorphanol group toward extractions. The
meperidine group had a statistically significant higher mean oxygen saturation during
treatment (99.63 percent) than the butorphanol group (99.20 percent). The butorphanol
group spent significantly more time in the annoyed ACS behavior rating code and showed
a trend toward less time spent in the quiet ACS behavior rating code. There were no
statistically significant differences in the three viewers ratings of global rating,
categorical, and dichotomous scales. The operators' ratings showed the meperidine group
had a statistically significant better global rating than the butorphanol group. Overall
butorphanol appears to be equal clinically to meperidine in physiologic effects and patient
behavior effects. No adverse effects occurred with either medication. Butorphanol may
be offered as an alternative sedative agent to other narcotic sedative agents with more side effects.
| Identifer | oai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/4139 |
| Date | January 2001 |
| Creators | Guthrie, Andrew C. (Andrew Cleveland), 1969- |
| Contributors | Sanders, Brian J., Majcher, Thomas, Tomlin, Angela, Weddell, James A. (James Arthur), 1949-, Avery, David R. |
| Source Sets | Indiana University-Purdue University Indianapolis |
| Language | en_US |
| Detected Language | English |
| Type | Thesis |
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