Investigation of the safety of intramuscular sedation in combination with ketamine and midazolam during dental treatment of uncooperative children

Abstract

Introduction: The management of the behavior of non-cooperative children cannot be separated from the quality of the doctor’s work, and although most of these children can be adapted by the usual behavioral management methods, some cannot be adapted. The "standard" has not yet been reached, and hence this research was directed towards studying the method of combination between ketamine and midazolam for use in uncooperative children who need dental treatment.

Objective: The aim of this research was to evaluate the degree of safety of combination between ketamine and midazolam in the management of behavior in non-cooperative children during dental treatment.

Materials and methods: A study was conducted on 25 non-cooperative boys and girls, aged between 4 and 9 years, from the Pediatric Dentistry Department at Damascus University, and the combination of midazolam 0.2 mg/kg and 2 mg/kg ketamine via the intramuscular route was applied to them. Vital signs were monitored and statistical study was conducted using T Student test.

Results: There were no statistically significant differences in the values of vital signs between the pre- and post-treatment stages. While there was a rise in the values of systolic and diastolic pressure and pulse during work. But this rise remained within the normal rates.

Conclusions: From this study, we conclude that the combination of ketamine and midazolam by intramuscular sedation in uncooperative children is a safe method in terms of vital signs (blood pressure, pulse, oxygen saturation, and respiratory rate).