Assessing Pediatric Sedation Using Patient-Centered Outcomes

Objective: To evaluate pediatric dental sedation success using patient-centered outcomes overall and for behavior, safety, and treatment. Methods: A cross-sectional study used existing clinical data of children 24 to 60 months of age undergoing first-time sedations (2015-2020) at a children's hospital. Outcomes included behavior success (Frankl score 3-4), safety success (vital signs maintained within 2 SDs of age- and sex-based norms), and treatment success. Overall success was defined as success in at least 2 subcategories. Descriptive statistics, bivariate comparisons, and multiple variable logistic regression were performed. Results: In 824 subjects (52.3% female, median age 36 months), overall sedation success was 69.3% (behavior, 49.0%; safety, 79.5%; and treatment, 62.1%). Number of medications (1 vs ≥2) did not affect any outcome measures of success. However, oral vs intranasal midazolam alone had higher behavioral (59.4% vs 44.6%; P < .001) and safety (85.6% vs 76.1%; P = .006) success rates. Age (OR, 95% CI; 1.75, 1.43-2.14; P < .001), male sex (5.53, 1.15-2.18; P = .01), and cooperative presedation behavior (1.79, 1.27-2.53; P = .001) significantly increased the odds of overall success. Conclusion: Overall sedation success was approximately 69.3%. Combination regimens were not associated with increased measures of success. Older age, male sex, and cooperative presedation behavior all predicted overall success.