Comparison of oral Midazolam and Midazolam-Ketamine as sedative agents in paediatric dentistry

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ABSTRACT

Aim

We compared the efficacy of sedation with oral Midazolam and a combination of oral Midazolam and
Ketamine, used as alternatives to general anaesthesia during tooth extraction. Study Design: Retrospective study.

Methods

A total of 30 patients aged between 3 and 9 years, who had elective tooth extraction were
included in the study. Subjects in Group A (n. 15) were given 0.75 mg/kg Midazolam orally while those in Group B (n. 15)
were given 0.75 mg/kg Midazolam orally + 5 mg/kg ketamine. Acceptance of orally administered drugs, sedation and anxiety
scores and reactions to local anaesthetic injection and tooth extraction were assessed.

Results

Sedation and anxiety
scores in Group B were better than in Group A (p<0.05). Reactions to local anaesthetic injection and tooth extraction were very significantly less common in Group B (p<0.0001). Requirement for an additional medication was more common in Group A (p<0.05). Side effects were not observed in either group. Statistics: Patient demographics and time to discharge were analysed by Mann-Whitney U test, whereas Chi-square test was used to analyse compliance to sedation, anxiety and sedation scores, reaction to tooth extraction, side effects and additional drug requirement.

Conclusion

Compared to oral
Midazolam only, a combination of oral Midazolam+Ketamine resulted in better sedation and surgical comfort in children
during a painful procedure such as tooth extraction.

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