Evaluation of relatively low dose of oral transmucosal ketamine premedication in children: a comparison with oral midazolam

Abstract

These results indicate that a relatively low dose of oral transmucosal ketamine premedication provides no benefits over oral midazolam in children.

Current methods of sedation in dental patients - a systematic review of the literature

“…Ketamine is a dissociative anesthetic and analgesic that is also used as a sedative drug, maintaining the patient’s muscle tone and the respiratory system’s protective reflexes (29,31). However, in adults, ketamine may also cause hallucinations and nightmares during the recovery period, and as such it sees limited use in adults; these side effects are rarely seen in children (31).…”

“…However, in adults, ketamine may also cause hallucinations and nightmares during the recovery period, and as such it sees limited use in adults; these side effects are rarely seen in children (31). …”

The effect of transmucosal 0.2 mg/kg midazolam premedication on dental anxiety, anaesthetic induction and psychological morbidity in children undergoing general anaesthesia for tooth extraction

“…Behaviour at anaesthetic induction, postoperative psychological morbidity and subsequent dental attendance were not found to differ between the premedication groups. more benefi cial effects, 22 Ko et al have shown 0.2 mg/kg to be effective in reducing emergence agitation and postoperative analgesic requirements. 23 Moreover, Erlandsson et al have reported this dose to be effective for conscious sedation of uncooperative paediatric dental patients.…”

Premedication of the pediatric patient – anesthesia for the uncooperative child

“…Oral administration is associated with high hepatic first-pass effect; only 16% of a given dose is bioavailable [22]. Horiuchi et al [23] reported the use of transmucosal ketamine in the form of a lollipop containing 50 mg ketamine (48 ml ¼ 2400 mg ketamine in a candy base and 12 mg of atropine sulfate preparation divided into 48 equal lollipop pieces and refrigerated), but could not show any superiority over midazolam 0.5 mg/kg. Ketamine provides sedation by 20-25 min, and leads to calm separation and good induction.…”