A DOUBLE-BLIND RANDOMIZED COMPARISON OF MIDAZOLAM ALONE AND MIDAZOLAMCOMBINED WITH KETAMINE FOR SEDATION OF PEDIATRIC DENTAL PATIENTS

Purpose: The safety and efficacy of a new sedation technique for child ren having dental procedures under local anesthesia were evaluated. Ma terials and Methods: One hundred children between the ages of 2 and 7 years who required sedation for dental procedures were administered ei ther a combination of midazolam (0.35 mg/kg) and ketamine (5 mg/kg) or midazolam alone (1 mg/kg) rectally 30 minutes before removal to the d ental chair, Pulse rate, respiratory rate, arterial pressure, oxygen s aturation, adverse reactions, postoperative recovery, and behavior wer e recorded. Results: Satisfactory sedation and anxiolysis were achieve d with both drugs used in the study. When evaluating postoperative rec overy, statistically significantly more children receiving midazolam a lone were fully awake on admission to the recovery room and 30 minutes later. Results of physiologic monitoring, behavioral ratings, and adv erse effects are reported. Excessive salivation occurred in 26% of chi ldren receiving the combination of drugs, compared with 14% receiving midazolam alone. Seven (14%) of the children receiving the combination of drugs hallucinated, compared with 21 (42%) receiving midazolam alo ne, Both drug groups had reliably good anxiolysis and sedation without loss of respiratory drive or protective airway reflexes, Conclusion: The use of a combination of midazolam and ketamine or midazolam alone is a safe, effective, and practical approach to managing children for minor dental procedures under local anesthesia. With this technique, a dvanced airway management proficiency is recommended.