Aphthasol
Cleft lip repair using intramuscular hydroxyzine sedation and local anesthesia.

Kapetansky D, Warren R, Hawtof D.

Wayne State University, Southfield, Michigan.

Intramuscular hydroxyzine was used alone for sedation in 18 cleft lip repairs with patients under 6 weeks of age. After injection of local anesthesia, the infants were quiet throughout the procedure. Blood pressure, pulse, respiration, and temperatures were normal throughout and the oxygen saturation remained above 94% in all cases. There were no complications noted with this series of patients and no patient required conversion to general anesthesia. Intramuscular hydroxyzine combined with local anesthesia and nerve block has been found to be a safe and effective method for cleft lip repairs in selected neonates under 6 weeks of age.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1472530&dopt=Abstract hydroxyzine Atarax



Aphthasol
Evaluation of the effect of nitrous oxide and hydroxyzine in controlling the behavior of the pediatric dental patient.

Shapira J, Holan G, Guelmann M, Cahan S.

Hadassah School of Dental Medicine, Jerusalem.

This study evaluated and compared the effect of three different sedation combinations on the young dental patient: hydroxyzine alone, hydroxyzine with nitrous oxide, and nitrous oxide alone. Nineteen uncooperative children with mean age of 37 months needing at least three restorative visits were selected for this study. Crying, alertness, and general behavior were evaluated during the dental procedure. The combination of hydroxyzine and nitrous oxide was more effective than the others for the majority of the sessions in terms of controlling crying and alertness. The results in the present study indicate that the sedative effect of hydroxyzine on children's behavior is enhanced by the addition of nitrous oxide.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1528785&dopt=Abstract hydroxyzine Atarax



Aphthasol
Cetirizine: actions on neurotransmitter receptors.

Snowman AM, Snyder SH.

Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205-2105.

First-generation H1-antagonist antihistamines, such as hydroxyzine, have the ability to cross the blood-brain barrier and cause sedation, which limits their usefulness in the treatment of allergic disorders. Cetirizine, a carboxylated metabolite of hydroxyzine, possesses the parent compound's antihistaminic activity but causes less sedation. We compared the activity of cetirizine at central H1 sites with that of hydroxyzine and terfenadine. We also compared the ability of cetirizine and three antihistamines to cross the blood-brain barrier. In each case we found that the drug's potency at H1 receptors in the central nervous system was similar to its activity in displacing H1 receptors in the lung. However, the selectivity for H1 receptors varied widely from drug to drug. Cetirizine did not bind at any of the receptors investigated, except H1 sites, even at concentrations as high as 10 mumol/L. Hydroxyzine and dexchlorpheniramine and, to a lesser extent, terfenadine crossed the blood-brain barrier in significant amounts. Cetirizine passed into the central nervous system only half as readily as terfenadine. These findings suggest that cetirizine's low incidence of sedative effects is most likely caused by its diminished potential to cross the blood-brain barrier and also may be partly the result of its greater selectivity for H1 receptors, compared with its effect at other receptors that may be involved in sedation.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1979798&dopt=Abstract hydroxyzine Atarax



Aphthasol
Comparison of triazolam to a chloral hydrate/hydroxyzine combination in the sedation of pediatric dental patients.

Meyer ML, Mourino AP, Farrington FH.

The purpose of this study was to compare the effectiveness of triazolam to chloral hydrate with hydroxyzine when sedating young children for dental treatment. Twenty children, age 21 to 74 months, with a mean age of 44 months, were given triazolam. Twenty children, age 23 to 64 months, with a mean age of 42 months, were given chloral hydrate with hydroxyzine. The children were given an elixir of either .02 mg/kg triazolam or 40 mg/kg chloral hydrate with 25 mg hydroxyzine. All subjects received 50% nitrous oxide and were restrained with a Papoose Board. The sedations were videotaped and evaluated by two pediatric dentists not involved in the study. They rated the success of the sedations by degree of sleep, crying, body movements, and overall behavior. Time until onset of action of the agents given, oxygen saturation of arterial blood, and heart rate were measured. The vital signs were consistent for the two groups. There was no statistical difference in the effectiveness of sedation between the two groups.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2095538&dopt=Abstract hydroxyzine Atarax



Aphthasol
Comparison of a chloral hydrate/hydroxyzine combination with and without meperidine in the sedation of pediatric dental patients.

Poorman TL, Farrington FH, Mourino AP.

The purpose of this study was to compare the effectiveness of a chloral hydrate/hydroxyzine combination with and without meperidine in the sedation of pediatric dental patients. Twenty children were given 40 mg/kg chloral hydrate and 25 mg hydroxyzine, and 20 children were given 40 mg/kg chloral hydrate and 25 mg hydroxyzine and 0.5 mg/kg meperidine. All children were between the ages of 24 and 60 months and all medications were given orally 1 hr before treatment. The children received 50% nitrous oxide for the entire procedure. All children were restrained in a Papoose Board. The patients were videotaped and their behavior was rated by two independent pediatric dentists using the Houpt Scale. The independent evaluators did not know which sedation regimen had been used. They rated success of the sedations by degree of sleep, crying, body movements, and overall behavior. Oxygen saturation of arterial blood, and heart rate also were measured. The vital signs were consistent for the two groups. There was no significant difference in the effectiveness of the two drug regimens.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2095539&dopt=Abstract hydroxyzine Atarax