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Fallahinejad Ghajari M, Ansari G, Soleymani AA, et al. Comparison of Oral and Intranasal Midazolam/Ketamine Sedation in 3-6-year-old Uncooperative Dental Patients. J Dent Res Dent Clin Dent Prospects. 2015;9(2):61-5doi: 10.15171/joddd.2015.013.
Fallahinejad Ghajari, M., Ansari, G., Soleymani, A. A., Shayeghi, S., & Fotuhi Ardakani, F. (2015). Comparison of Oral and Intranasal Midazolam/Ketamine Sedation in 3-6-year-old Uncooperative Dental Patients. Journal of dental research, dental clinics, dental prospects, 9(2), 61-5. https://doi.org/10.15171/joddd.2015.013
Fallahinejad Ghajari, Masoud, et al. "Comparison of Oral and Intranasal Midazolam/Ketamine Sedation in 3-6-year-old Uncooperative Dental Patients." Journal of dental research, dental clinics, dental prospects vol. 9,2 (2015): 61-5. doi: https://doi.org/10.15171/joddd.2015.013
Fallahinejad Ghajari M, Ansari G, Soleymani AA, Shayeghi S, Fotuhi Ardakani F. Comparison of Oral and Intranasal Midazolam/Ketamine Sedation in 3-6-year-old Uncooperative Dental Patients. J Dent Res Dent Clin Dent Prospects. 2015;9(2):61-5. doi: 10.15171/joddd.2015.013. Epub 2015 Jun 10. PMID: 26236429; PMCID: PMC4517191.
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J Dent Res Dent Clin Dent Prospects. 2015;9(2):61-5. doi: 10.15171/joddd.2015.013. Epub 2015 Jun 10.

Comparison of Oral and Intranasal Midazolam/Ketamine Sedation in 3-6-year-old Uncooperative Dental Patients.

Journal of dental research, dental clinics, dental prospects

Masoud Fallahinejad Ghajari, Ghassem Ansari, Ali Asghar Soleymani, Shahnaz Shayeghi, Faezeh Fotuhi Ardakani

Affiliations

  1. Associate Professor & Head, Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  2. Professor, Research Institute of Dental Sciences, Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  3. Assistant Professor, Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
  4. Associate Professor, Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  5. Assistant Professor, Department of Pediatric Dentistry, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

PMID: 26236429 PMCID: PMC4517191 DOI: 10.15171/joddd.2015.013

Abstract

Background and aims. There are several known sedative drugs, with midazolam and ketamine being the most commonly used drugs in children. The aim of this study was to compare the effect of intranasal and oral midazolam plus ketamine in children with high levels of dental anxiety. Materials and methods. A crossover double-blind clinical trial was conducted on 23 uncooperative children aged 3-6 (negative or definitely negative by Frankel scale), who required at least two similar dental treatment visits. Cases were randomly given ketamine (10 mg/kg) and midazolam (0.5 mg/kg) through oral or intranasal routes in each visit. The sedative efficacy of the agents was assessed by an overall success rate judged by two independent pediatric dentists based on Houpt's scale for sedation. Data analysis was carried out using Wilcoxon test and paired t-test. Results. Intranasal administration was more effective in reduction of crying and movement during dental procedures compared to oral sedation (P<0.05). Overall behavior control was scored higher in nasal compared to oral routes at the time of LA injection and after 15 minutes (P<0.05). The difference was found to be statistically significant at the start and during treatment. However, the difference was no longer significant after 30 minutes, with the vital signs remaining within physiological limits. Recovery time was longer in the intranasal group (P<0.001) with a more sleepy face (P=0.004). Conclusion. . Intranasal midazolam/ketamine combination was more satisfactory and effective than the oral route when sedating uncooperative children.

Keywords: Anxiety; intranasal; ketamine; midazolam; oral sedation

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