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

Abstract

Abstract

Introduction: Non-cooperative behavior in the dental clinic is the biggest challenge for pediatric dentists, and sedation is of great benefit in reducing anxiety and in behavioral management in children, and despite the abundance of research on sedative drugs; However, the "standard" analgesic 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 4 mg/kg ketamine via the nasal route was applied to them. Vital signs were recorded and the statistical study was performed 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 nasal sedation in uncooperative children is a safe method in terms of vital signs (blood pressure, pulse, oxygen saturation, and respiratory rate).

Keywords: sedation, ketamine, midazolam, atropine, children.