Pain and anxiety management for pediatric dental procedures using various combinations of sedative drugs: A review

Gazal, Giath; Fareed, Wamiq Musheer; Zafar, Muhammad Sohail; Al-Samadani, Khalid H

doi:10.1016/j.jsps.2014.04.004

Cited by 42 publications

(43 citation statements)

References 37 publications

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“…Pada dosis tinggi ketamin dapat menimbulkan aktivitas eksitatori pada sistem talamus dan limbik. 12,13 Midazolam adalah golongan benzodiazepin larut air yang memiliki cincin imidazol. Awitan kerja obat 1 hingga 3 menit, waktu paruh distribusi 6 hingga 15 menit, dan waktu paruh 1,5 sampai 2 jam.…”

Section: Pembahasanunclassified

Perbandingan Efektivitas dan Keamanan Kombinasi Ketamin/Midazolam Dibandingkan Ketamin Tunggal sebagai Sedasi pada Anak

Andriastuti

Kartika²,

2017

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Latar belakang. Penambahan midazolam sebelum pemberian ketamin sebagai obat sedasi pada tindakan aspirasi sumsum tulang atau pemberian kemoterapi intratekal terbukti meningkatkan efektivitas sedasi, mengurangi ansietas dan mengurangi efek samping ketamin yaitu mimpi buruk, halusinasi, dan fenomena pulih sadar pasca pemberian ketamin. Tujuan. Membandingkan efektivitas dan keamanan sedasi antara kombinasi ketamin/midazolam dan ketamin tunggal berdasarkan bukti ilmiah. Metode. Penelusuran pustaka database elektronik melalui Pubmed, Clinical Key, dan Google Scholar. Hasil. Suatu uji klinis acak tersamar mendapatkan awitan sedasi secara signifikan lebih singkat pada kelompok ketamin/midazolam dibandingkan ketamin yaitu 2,6 menit dan 3,4 menit (nilai p= 0,01). Jumlah subjek yang mengalami amnesia total pada kelompok ketamin/midazolam dibandingkan ketamin yaitu 100% dan 80,3% (p=0,001). Kejadian mimpi buruk pada kelompok ketamin/ midazolam dibandingkan ketamin 6,3% dan 19,6% (p=0,04). Lima uji kohort menunjukkan kombinasi ketamin/midazolam dapat menjadi pilihan sedasi yang cepat, efektif, dan aman bagi anak yang akan menjalani berbagai tindakan di bidang hematologi-onkologi. Kombinasi ini aman dan efisien untuk mengurangi nyeri selama prosedur dan mengurangi kecemasan pasien dan orangtua. Kesimpulan. Berdasarkan penelitian ilmiah yang telah dipaparkan, penambahan midazolam pada ketamin tidak menambah efek samping, dan kombinasi ini lebih baik dibandingkan ketamin tunggal. Sari Pediatri 2016;18(3):240-4Kata kunci : ketamin, midazolam, sedasi, anak The Efficacy and Safety of Sedation Using Midazolam and Ketamine Combination to a Single Ketamine Based on Scientific EvidenceMurti Andriastuti,* Dewi Kartika S,* Andi Ade Wijaya Ramlan** Background. Several studies have shown that the addition of midazolam on ketamine sedation can increase effectiveness, reduce anxiety and reduce side effects of ketamine in the form of nightmare, hallucinations, and agitation emergence. Objective. To compare the efficacy and safety of sedation using midazolam and ketamine combination to a single ketamine based on scientific evidence. Methods. Literature search use the electronic databases: Pubmed, Clinical Key and Google Scholar. Results. A randomized clinical trial showed that onset of sedation was significantly shorter in the combination compare to single ketamine group (2.6 vs 3.4 minutes, p=0.01). The number of subjects who experienced total amnesia in ketamine/midazolam compare to single ketamine group was 100% and 80.3% (p = 0.001). Nightmare / crying spells in combination compare to single ketamine group was 6. 3% and 19.6 (p = 0.04). Five cohort showed a combination of ketamine and midazolam sedation may be an option that is fast, effective, and safe for children who will undergo various actions in the field of hematology-oncology. This combination is a safe and efficient method to reduce pain during the procedure and reduce anxiety of patients and parents. Conclusion. Based on scientific research that has been presented, the addition...

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Section: Pembahasanunclassified

Perbandingan Efektivitas dan Keamanan Kombinasi Ketamin/Midazolam Dibandingkan Ketamin Tunggal sebagai Sedasi pada Anak

Andriastuti

Kartika²,

2017

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“…Conventionally, the pain management involves using analgesics [30,31,32] and sedatives [33]. Gene therapy is being investigated for improving management of chronic pain by sparing the use of drugs with the associated risk of systemic toxicity, opioid addiction and other side effects [34].…”

Section: Applications In Dentistrymentioning

confidence: 99%

Gene Therapy: A Paradigm Shift in Dentistry

Siddique

Raza

Ahmed

et al. 2016

Genes

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Gene therapy holds a promising future for bridging the gap between the disciplines of medicine and clinical dentistry. The dynamic treatment approaches of gene therapy have been advancing by leaps and bounds. They are transforming the conventional approaches into more precise and preventive ones that may limit the need of using drugs and surgery. The oral cavity is one of the most accessible areas for the clinical applications of gene therapy for various oral tissues. The idea of genetic engineering has become more exciting due to its advantages over other treatment modalities. For instance, the body is neither subjected to an invasive surgery nor deep wounds, nor is it susceptible to systemic effects of drugs. The aim of this article is to review the gene therapy applications in the field of dentistry. In addition, therapeutic benefits in terms of treatment of diseases, minimal invasion and maximum outcomes have been discussed.

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“…It can be safely combined with intranasal fentanyl. Another agent frequently used in pediatric is ketamine which can also be given through various route [69][70][71] . Propofol and dexmedetomidine is also being increasingly used in paediatric procedural sedation.…”

Section: Benzodiazepines (Bzd)mentioning

confidence: 99%