Intravenous ketamine, propofol and propofol-ketamine combination used for pediatric dental sedation: A randomized clinical study

Abstract

Background and objective: Dental treatments cannot bealways performed under local anesthesia inpediatric non-cooperative patients. For this purpose, differentanesthetic techniques have been applied to increase patient comport to dental treatments.

Methods: Sixty children classified as ASA I-II, between aged 3 to 9, who were scheduled to undergo tooth extraction, were enrolled for this randomized study. Group K received 1 mg/kg ketamine, Group P received 1 mg/kg propofol, and Group KP received 0.5 mg/kg propofol plus 0.5 mg/kg ketamine intravenously for anesthesia induction.

Results: Recovery time was significantly lower in Group P than Group KP. No significant differences were found between groups regarding HR, before and after the induction, at tenth minute. Fifth minute's HR was higher in Group K than Group KP. Mean arterial pressure (MAP) values were similar at baseline, before and after the induction, and at tenth minute, whereas significantly lower values were found in Group P and Group KP than in Group K at fifth minute.

Conclusions: Although ketamine, propofol and ketamine-propofol combination are effective for sedation in tooth extraction in pediatric patients, propofol may be an excellent alternative, with the shortest recovery, no nausea and vomiting, and reasonable surgical satisfaction.

Keywords: Ketamine; Propofol; Sedation; Tooth extraction.

Fig.1

Heart Rate of the groups (beat/min) ^aHigher in Group K than Group KP, ^bSignificant increase compared with baseline.

Fig.2

Mean arterial pressure of the groups (mmHg). ^aSignificant decrease compared with Group K, ^cSignificant decrease compared with Group KP, ^bSignificant increase compared with basaline