human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM This study compared the effect of two different dosages of hydroxyzine supported by 50 % nitrous oxide inhalation sedation in child patients . SUBJECTS AND METHODS Thirty uncooperative healthy children with an age range of 31 - 120 months were included in this study . Patients were r and omly assigned into two groups . The patients in group 1 were given 20 mg of hydroxyzine ( Atarax ) 24 h preoperatively and on the operation day , 3.7 mg/kg hydroxyzine was administered orally . The patients in group 2 received 3.7 mg/kg hydroxyzine orally only on the operation day . All patients also received 50 % nitrous oxide inhalation sedation . The child 's behaviour was evaluated every 5 min by using Houpt Sedation Rating Scale . The oxygen saturation and heart rates were also followed . RESULTS The mean age of the children in the study was 61.9 months ( SD 11.9 ) for group 1 and 53.7 months ( SD 12.8 ) for group 2 . Evaluation of the results showed that there were no significant differences ( P < 0.05 ) between behavioural attitudes and sedation degree of the patients . CONCLUSIONS Twenty milligrams of hydroxyzine administered 24 h preoperatively has no significant benefit on sedation of the child Background Results of previous studies of rectal ketamine as a pediatric premedication are clouded because of lack of dose – response relation , inappropriate time of assessing sedative effects , and previous administration or coadministration of benzodiazepines . Therefore , the authors reevaluated the efficacy of rectally administered ketamine in comparison with 1 mg/kg rectal midazolam . Methods Sixty-six infants and children ( age , 7–61 months ) who were American Society of Anesthesiologists physical status I and who were undergoing minor surgeries as in- patients were r and omized to receive 5 mg/kg ketamine ( n = 16 ) , 7 mg/kg ketamine ( n = 16 ) , 10 mg/kg ketamine ( n = 17 ) , or 1 mg/kg midazolam ( n = 17 ) via rectum . A blinded observer scored sedation 45 min and 15 min after administration of ketamine and midazolam , respectively , when children were separated from parent(s ) for inhalational induction . All children underwent st and ardized general anesthesia with sevoflurane , nitrous oxide , and oxygen with endotracheal intubation .  Blood pressure , heart rate , and oxyhemoglobin saturation were determined before , during , and after anesthesia . Postoperative recovery characteristics and incidence of adverse reactions were also assessed . Results Most children ( 88 % ) who received rectally 10 mg/kg ketamine or 1 mg/kg midazolam  separated easily from their parents compared with those ( 31 % ) who received 7 or 5 mg/kg rectal ketamine ( P < 0.05 ) . Similarly , more children who received 10 mg/kg ketamine or 1 mg/kg midazolam underwent mask induction without struggling or crying compared with those who received 7 or 5 mg/kg ketamine ( P < 0.05 ) . There were no clinical ly significant changes in blood pressure , heart rate , and oxyhemoglobin saturation after administration of either drug . Immediately after surgery , more children receiving midazolam or 5 mg/kg ketamine were agitated compared with 7 or 10 mg/kg ketamine . Ketamine , 7 and 10 mg/kg , provided postoperative analgesia , but the largest dose of ketamine was associated with delayed emergence from general anesthesia . Conclusions The results indicate that rectally administered ketamine alone produces dose-dependent sedative effects in children , when evaluated at its predicted peak plasma concentration . Ketamine , 10 mg/kg , has a delayed onset but is as effective as 1 mg/kg midazolam for sedating healthy children before general anesthesia . However , 10 mg/kg rectal ketamine is not recommended for brief surgeries because of prolonged postoperative sedation PURPOSE The purpose of this study was to evaluate the potential of using capnography to analyze respiratory sample s taken from a scavenging nitrous oxide nasal hood during routine pediatric dental procedures . METHODS Twenty-two subjects , aged 60 - 116 months , were administered alternately either 40 % nitrous oxide/60 % oxygen or 100 % oxygen during two sequential restorative appointments . All subjects were monitored continuously for end-tidal carbon dioxide and respiratory rate using a capnograph whose sampling line was attached directly to the nitrous oxide nasal hood . The subject 's breath sound , displayed behavior , type of dental procedure being performed , and presence of rubber dam isolation were recorded every minute throughout the two appointments . RESULTS Values for end-tidal carbon dioxide and respiratory rate were displayed on the capnograph when administering either oxygen or a combination of nitrous oxide/oxygen inhalation through the nasal hood . These respiratory values were lowered significantly when comparing 40 % nitrous oxygen-60 % oxygen to 100 % oxygen inhalation . They were not significantly altered by the type of breath sound , patient behavior , dental procedure , or presence of rubber dam isolation , with the exception of some dental procedures which significantly lowered end-tidal carbon dioxide . The apnea alarm on the capnograph occurred during 5 % of the total treatment time , but its occurrence represented a 97 % false positive rate . The occurrence of the apnea alarm was significantly associated with the type for breath sound , patient behavior , and dental procedure . When used in this manner , the capnograph was effective in alerting the practitioner to potential apneic events , but likely has limited value in monitoring valid end-tidal carbon dioxide levels due to limitations in the sampling technique . CONCLUSIONS This study demonstrated the potential of the capnograph as a respiratory monitor for pediatric dental patients when the sampling line was attached to a scavenging nitrous oxide nasal hood This study was conducted to examine the effects of chloral hydrate on  nitrous oxide sedation  of young children for dental treatment . Nineteen children , ranging in age from 19 to 41 months ( mean 30 months ) , participated in this double-blind study . The subjects were assigned r and omly to receive either a placebo or chloral hydrate ( 50 mg/kg ) for the first visit with the alternate regimen administered during the second appointment . In addition , all subjects received inhalation nitrous oxide/oxygen at a concentration of 50 % , and were restrained in a Papoose board ( Olympic Medical Group ; Seattle , WA ) with head restraint . Seventy-four per cent of sedations were classified as very good or excellent when chloral hydrate was administered with nitrous oxide compared with only 26 % when the placebo was administered Using double-blind conditions , 60 uncooperative and fearful preschool children ( 24 - 66 months ) received intramuscular injections of meperidine 0.25 , 0.50 , 1.00 mg/lb or placebo prior to restorative dental treatment .  Behavior was assessed by the dentist and an independent observer during five specific treatment procedures . Behavioral ratings found meperidine to be an effective sedative , with 0.50 mg/lb and 1.00 mg/lb being significantly more effective than placebo ( P less than 0.05 , Kruskal-Wallis ) . Children receiving 1.0 mg/lb of meperidine had significantly more nausea and vomiting than patients receiving lower doses of the drug ( P less than 0.05 , Chisquare ) . Physiologic monitoring demonstrated that the highest dose of meperidine was associated with transient drops in arterial oxygen saturation .  Meperidine sedation was found to be more effective for older children ( 37 - 66 months ) and for children initially rated as being only moderately uncooperative and fearful This study compared the incidence of vomiting and the sedative effectiveness of ketamine to a ketamine-prornethazine combination in pediatric dental patients . Twenty-two patients with American Society of Anesthesiologists ' classification I physical status who were between the ages of 21 and 43 months were r and omly divided into 2 groups . The control group received 10 mg/kg of ketamine orally , whereas the experimental group received 10 mg/kg of ketamine and 1.1 mg/kg of promethazine orally . Nitrous oxide in oxygen was supplemented between 35 and 50 % . Each patient received 1 or 2 quadrants of restoration by one operator . Heart rate , blood pressure , and oxygen saturation were monitored and recorded during the treatment . Crying , alertness , movement , and overall general behavior were rated using the scale by Houpt et al. A dentist-anesthesiologist conducted the vital sign monitoring and behavioral assessment . Ketamine combined with promethazine eliminated the incidence of vomiting . A 2 x 2 chi-square contingency table showed a statistical difference between the 2 groups at P < .05 ( control group , 27 % ; experimental group , 0 % ) . Ketamine alone yielded better sedations than the combined agents as shown by the Mann-Whitney U statistical analysis ( P < .05 ) . Ketamine and a ketamine-promethazine combination are effective in the sedation of pediatric dental patients PURPOSE This study was design ed to examine the efficacy and safety of submucosal ( SM ) midazolam and oral chloral hydrate ( CH ) when used for pediatric conscious sedation in a clinical dental environment . METHODS Twenty children ages 32 to 63 months participated in this institutionally approved study . Selection criteria included good health ( ASA I ) , 2 to 5 years of age , uncooperative behavior , and the need for multiple restorative visits . In a double-blind crossover design , patients were r and omly assigned to receive either oral CH ( 50 mg/kg ) and SM midazolam ( 0.2 mg/kg ) , or oral CH ( 50 mg/kg ) and SM saline placebo on their first sedation visit . On the second sedation visit , the patient received the opposite drug regimen than the first visit . Nitrous oxide ( 50 % ) was used during each sedation visit . Behavior response was rated as quiet ( Q ) , crying ( C ) , movement ( M ) , or struggling ( S ) every 2.5 minutes through 40 minutes of operative procedures . Sedations were monitored using a capnograph , pulse oximeter , an automated blood pressure cuff , and precordial stethoscope . Respiratory rate ( RR ) , heart rate ( HR ) , and blood pressure ( BP ) were evaluated for each procedure . Data was analyzed using ANOVA and multinomial repeated- measures logistic regression . RESULTS Analysis showed a significant difference in behavior during sedation across drug regimen ( chi-square = 55.6 , df = 3 , P < .0001 ) . Patients given SM midazolam in addition to oral CH showed increased Q rating and decreased C , M , and S ratings . RR , BP , and HR for both groups remained within the normal values for 2- to 5-year-olds . CONCLUSIONS SM midazolam improved the quality of sedation without compromising safety . Quiet behavior was increased and struggling behavior was decreased . In addition , mean HR , RR , and BP analysis did not deviate from the norm for this age group PURPOSE The purpose of this study was to compare the effectiveness of midazolam ( MDZ ) alone to a combination of MDZ and hydroxyzine ( MDZH ) when sedating young children for dental treatment . METHODS This was a prospect i ve , double-blinded , crossover clinical study of young uncooperative children in need of at least 2 restorative visits . Twenty-eight children , ages 21 to 56 months , with a mean age of 36.6 months , participated in this study . The subjects were assigned r and omly to receive either 0.5 mg/kg of oral MDZ 20 minutes prior to the beginning of dental treatment or the combination of 0.3 mg/kg oral MDZ with 3.7 mg/kg of hydroxyzine 30 minutes before treatment . The alternative drug regimen was administered at the second appointment . All subjects also received 50 % nitrous oxide and were restrained with a papoose board . The child 's behavior ( quiet or crying , relaxed or moving ) was evaluated every 5 minutes by an experienced pediatric dentist who was unaware of the drug given to the child . At the conclusion of treatment , each session was evaluated for overall effectiveness . RESULTS Regardless of the type of premedication , more patients exhibited quiet behavior at the beginning of treatment , with an increase in crying and movement toward the end of treatment . Regarding movement , a significant difference was observed during the first 20 minutes between the 2 regimens . MDZ showed more children exhibiting movement . During the first 30 minutes of treatment , more children cried in the MDZ group , while MDZH presented more children asleep or quiet . No significant differences were found in behavior as a function of the order the sedative regimens were given . No significant differences between the 2 regimens regarding overall behavior and success ( t=0.655 at 27 degrees of freedom ; P=.518 ) were found . CONCLUSIONS The combination of hydroxyzine ( 3.7 mg/kg ) with MDZ ( 0.3 mg/kg ) administered 30 minutes before treatment result ed in safe and effective sedation for the dental treatment of young children . This combination 's use might be more advantageous when compared to MDZ alone , result 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM This study compared the effect of two different dosages of hydroxyzine supported by 50 % nitrous oxide inhalation sedation in child patients . SUBJECTS AND METHODS Thirty uncooperative healthy children with an age range of 31 - 120 months were included in this study . Patients were r and omly assigned into two groups . The patients in group 1 were given 20 mg of hydroxyzine ( Atarax ) 24 h preoperatively and on the operation day , 3.7 mg/kg hydroxyzine was administered orally . The patients in group 2 received 3.7 mg/kg hydroxyzine orally only on the operation day . All patients also received 50 % nitrous oxide inhalation sedation . The child 's behaviour was evaluated every 5 min by using Houpt Sedation Rating Scale . The oxygen saturation and heart rates were also followed . RESULTS The mean age of the children in the study was 61.9 months ( SD 11.9 ) for group 1 and 53.7 months ( SD 12.8 ) for group 2 . Evaluation of the results showed that there were no significant differences ( P < 0.05 ) between behavioural attitudes and sedation degree of the patients . CONCLUSIONS Twenty milligrams of hydroxyzine administered 24 h preoperatively has no significant benefit on sedation of the child Background Results of previous studies of rectal ketamine as a pediatric premedication are clouded because of lack of dose – response relation , inappropriate time of assessing sedative effects , and previous administration or coadministration of benzodiazepines . Therefore , the authors reevaluated the efficacy of rectally administered ketamine in comparison with 1 mg/kg rectal midazolam . Methods Sixty-six infants and children ( age , 7–61 months ) who were American Society of Anesthesiologists physical status I and who were undergoing minor surgeries as in- patients were r and omized to receive 5 mg/kg ketamine ( n = 16 ) , 7 mg/kg ketamine ( n = 16 ) , 10 mg/kg ketamine ( n = 17 ) , or 1 mg/kg midazolam ( n = 17 ) via rectum . A blinded observer scored sedation 45 min and 15 min after administration of ketamine and midazolam , respectively , when children were separated from parent(s ) for inhalational induction . All children underwent st and ardized general anesthesia with sevoflurane , nitrous oxide , and oxygen with endotracheal intubation .  Blood pressure , heart rate , and oxyhemoglobin saturation were determined before , during , and after anesthesia . Postoperative recovery characteristics and incidence of adverse reactions were also assessed . Results Most children ( 88 % ) who received rectally 10 mg/kg ketamine or 1 mg/kg midazolam  separated easily from their parents compared with those ( 31 % ) who received 7 or 5 mg/kg rectal ketamine ( P < 0.05 ) . Similarly , more children who received 10 mg/kg ketamine or 1 mg/kg midazolam underwent mask induction without struggling or crying compared with those who received 7 or 5 mg/kg ketamine ( P < 0.05 ) . There were no clinical ly significant changes in blood pressure , heart rate , and oxyhemoglobin saturation after administration of either drug . Immediately after surgery , more children receiving midazolam or 5 mg/kg ketamine were agitated compared with 7 or 10 mg/kg ketamine . Ketamine , 7 and 10 mg/kg , provided postoperative analgesia , but the largest dose of ketamine was associated with delayed emergence from general anesthesia . Conclusions The results indicate that rectally administered ketamine alone produces dose-dependent sedative effects in children , when evaluated at its predicted peak plasma concentration . Ketamine , 10 mg/kg , has a delayed onset but is as effective as 1 mg/kg midazolam for sedating healthy children before general anesthesia . However , 10 mg/kg rectal ketamine is not recommended for brief surgeries because of prolonged postoperative sedation PURPOSE The purpose of this study was to evaluate the potential of using capnography to analyze respiratory sample s taken from a scavenging nitrous oxide nasal hood during routine pediatric dental procedures . METHODS Twenty-two subjects , aged 60 - 116 months , were administered alternately either 40 % nitrous oxide/60 % oxygen or 100 % oxygen during two sequential restorative appointments . All subjects were monitored continuously for end-tidal carbon dioxide and respiratory rate using a capnograph whose sampling line was attached directly to the nitrous oxide nasal hood . The subject 's breath sound , displayed behavior , type of dental procedure being performed , and presence of rubber dam isolation were recorded every minute throughout the two appointments . RESULTS Values for end-tidal carbon dioxide and respiratory rate were displayed on the capnograph when administering either oxygen or a combination of nitrous oxide/oxygen inhalation through the nasal hood . These respiratory values were lowered significantly when comparing 40 % nitrous oxygen-60 % oxygen to 100 % oxygen inhalation . They were not significantly altered by the type of breath sound , patient behavior , dental procedure , or presence of rubber dam isolation , with the exception of some dental procedures which significantly lowered end-tidal carbon dioxide . The apnea alarm on the capnograph occurred during 5 % of the total treatment time , but its occurrence represented a 97 % false positive rate . The occurrence of the apnea alarm was significantly associated with the type for breath sound , patient behavior , and dental procedure . When used in this manner , the capnograph was effective in alerting the practitioner to potential apneic events , but likely has limited value in monitoring valid end-tidal carbon dioxide levels due to limitations in the sampling technique . CONCLUSIONS This study demonstrated the potential of the capnograph as a respiratory monitor for pediatric dental patients when the sampling line was attached to a scavenging nitrous oxide nasal hood This study was conducted to examine the effects of chloral hydrate on  nitrous oxide sedation  of young children for dental treatment . Nineteen children , ranging in age from 19 to 41 months ( mean 30 months ) , participated in this double-blind study . The subjects were assigned r and omly to receive either a placebo or chloral hydrate ( 50 mg/kg ) for the first visit with the alternate regimen administered during the second appointment . In addition , all subjects received inhalation nitrous oxide/oxygen at a concentration of 50 % , and were restrained in a Papoose board ( Olympic Medical Group ; Seattle , WA ) with head restraint . Seventy-four per cent of sedations were classified as very good or excellent when chloral hydrate was administered with nitrous oxide compared with only 26 % when the placebo was administered Using double-blind conditions , 60 uncooperative and fearful preschool children ( 24 - 66 months ) received intramuscular injections of meperidine 0.25 , 0.50 , 1.00 mg/lb or placebo prior to restorative dental treatment .  Behavior was assessed by the dentist and an independent observer during five specific treatment procedures . Behavioral ratings found meperidine to be an effective sedative , with 0.50 mg/lb and 1.00 mg/lb being significantly more effective than placebo ( P less than 0.05 , Kruskal-Wallis ) . Children receiving 1.0 mg/lb of meperidine had significantly more nausea and vomiting than patients receiving lower doses of the drug ( P less than 0.05 , Chisquare ) . Physiologic monitoring demonstrated that the highest dose of meperidine was associated with transient drops in arterial oxygen saturation .  Meperidine sedation was found to be more effective for older children ( 37 - 66 months ) and for children initially rated as being only moderately uncooperative and fearful This study compared the incidence of vomiting and the sedative effectiveness of ketamine to a ketamine-prornethazine combination in pediatric dental patients . Twenty-two patients with American Society of Anesthesiologists ' classification I physical status who were between the ages of 21 and 43 months were r and omly divided into 2 groups . The control group received 10 mg/kg of ketamine orally , whereas the experimental group received 10 mg/kg of ketamine and 1.1 mg/kg of promethazine orally . Nitrous oxide in oxygen was supplemented between 35 and 50 % . Each patient received 1 or 2 quadrants of restoration by one operator . Heart rate , blood pressure , and oxygen saturation were monitored and recorded during the treatment . Crying , alertness , movement , and overall general behavior were rated using the scale by Houpt et al. A dentist-anesthesiologist conducted the vital sign monitoring and behavioral assessment . Ketamine combined with promethazine eliminated the incidence of vomiting . A 2 x 2 chi-square contingency table showed a statistical difference between the 2 groups at P < .05 ( control group , 27 % ; experimental group , 0 % ) . Ketamine alone yielded better sedations than the combined agents as shown by the Mann-Whitney U statistical analysis ( P < .05 ) . Ketamine and a ketamine-promethazine combination are effective in the sedation of pediatric dental patients PURPOSE This study was design ed to examine the efficacy and safety of submucosal ( SM ) midazolam and oral chloral hydrate ( CH ) when used for pediatric conscious sedation in a clinical dental environment . METHODS Twenty children ages 32 to 63 months participated in this institutionally approved study . Selection criteria included good health ( ASA I ) , 2 to 5 years of age , uncooperative behavior , and the need for multiple restorative visits . In a double-blind crossover design , patients were r and omly assigned to receive either oral CH ( 50 mg/kg ) and SM midazolam ( 0.2 mg/kg ) , or oral CH ( 50 mg/kg ) and SM saline placebo on their first sedation visit . On the second sedation visit , the patient received the opposite drug regimen than the first visit . Nitrous oxide ( 50 % ) was used during each sedation visit . Behavior response was rated as quiet ( Q ) , crying ( C ) , movement ( M ) , or struggling ( S ) every 2.5 minutes through 40 minutes of operative procedures . Sedations were monitored using a capnograph , pulse oximeter , an automated blood pressure cuff , and precordial stethoscope . Respiratory rate ( RR ) , heart rate ( HR ) , and blood pressure ( BP ) were evaluated for each procedure . Data was analyzed using ANOVA and multinomial repeated- measures logistic regression . RESULTS Analysis showed a significant difference in behavior during sedation across drug regimen ( chi-square = 55.6 , df = 3 , P < .0001 ) . Patients given SM midazolam in addition to oral CH showed increased Q rating and decreased C , M , and S ratings . RR , BP , and HR for both groups remained within the normal values for 2- to 5-year-olds . CONCLUSIONS SM midazolam improved the quality of sedation without compromising safety . Quiet behavior was increased and struggling behavior was decreased . In addition , mean HR , RR , and BP analysis did not deviate from the norm for this age group PURPOSE The purpose of this study was to compare the effectiveness of midazolam ( MDZ ) alone to a combination of MDZ and hydroxyzine ( MDZH ) when sedating young children for dental treatment . METHODS This was a prospect i ve , double-blinded , crossover clinical study of young uncooperative children in need of at least 2 restorative visits . Twenty-eight children , ages 21 to 56 months , with a mean age of 36.6 months , participated in this study . The subjects were assigned r and omly to receive either 0.5 mg/kg of oral MDZ 20 minutes prior to the beginning of dental treatment or the combination of 0.3 mg/kg oral MDZ with 3.7 mg/kg of hydroxyzine 30 minutes before treatment . The alternative drug regimen was administered at the second appointment . All subjects also received 50 % nitrous oxide and were restrained with a papoose board . The child 's behavior ( quiet or crying , relaxed or moving ) was evaluated every 5 minutes by an experienced pediatric dentist who was unaware of the drug given to the child . At the conclusion of treatment , each session was evaluated for overall effectiveness . RESULTS Regardless of the type of premedication , more patients exhibited quiet behavior at the beginning of treatment , with an increase in crying and movement toward the end of treatment . Regarding movement , a significant difference was observed during the first 20 minutes between the 2 regimens . MDZ showed more children exhibiting movement . During the first 30 minutes of treatment , more children cried in the MDZ group , while MDZH presented more children asleep or quiet . No significant differences were found in behavior as a function of the order the sedative regimens were given . No significant differences between the 2 regimens regarding overall behavior and success ( t=0.655 at 27 degrees of freedom ; P=.518 ) were found . CONCLUSIONS The combination of hydroxyzine ( 3.7 mg/kg ) with MDZ ( 0.3 mg/kg ) administered 30 minutes before treatment result ed in safe and effective sedation for the dental treatment of young children . This combination 's use might be more advantageous when compared to MDZ alone , result 
    Output:
    