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

Purpose: The goal of this study is to determine the validity and reliability of the Modified Aldrete Score (MAS) and the Vancouver Recovery Score (VRS) and to compare the post-discharge effects of commonly used moderate pediatric dental sedation drugs. 

Methods: This prospective longitudinal cohort study recruited patients 6 years or younger, receiving dental treatment under moderate sedation between April 2022 and January 2025 at Bon Secours Pediatric Dental Associates. 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, 6) IN dexmedetomidine/IN Midazolam or 7) PO Triazolam. The patients were scored using the MAS and VRS pre-operatively and post-operatively for 20 minutes by both a nurse and resident. A parent survey about the patient’s behavior and recovery after leaving the office was collected after discharge.

Results: One-hundred patients were recruited in this study. The mean age was 5.3 years old with 51% male and 49% female. The residents’ and nurses’ VRS scores post-operatively agreed 73% of the time and the MAS score agreed 94% of the time. The parent surveys found 49% of children fell asleep on the ride home. After returning home, 44% were agitated, 56% were less active, and 36% returned to normal activity in 2-4 hours.

Conclusion: Based on the study’s current data, MAS and VRS are global scales to use for discharge criteria with moderate sedation. This is an ongoing study, final data is pending.

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