Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Sep-Oct;11(5):399-405.
doi: 10.5005/jp-journals-10005-1547. Epub 2018 Oct 1.

A Comparative Evaluation of the Sedative Effects of Nitrous Oxide-oxygen Inhalation and Oral Midazolam-Ketamine Combination in Children

Ilasrinivasan  1 , Jyothsna V Setty  2 , Shyamachalam  3 , Priya Mendiretta  3
Affiliations

A Comparative Evaluation of the Sedative Effects of Nitrous Oxide-oxygen Inhalation and Oral Midazolam-Ketamine Combination in Children

Ilasrinivasan et al. Int J Clin Pediatr Dent. 2018 Sep-Oct.

Abstract

Aims: To compare nitrous oxide-oxygen inhalation and low dose oral midazolam-ketamine combination for anxiolysis in the management of children aged between 3 to 10 years for dental treatment.

Materials and methods: A comparative clinical study with equal number of subjects in both the groups evaluating efficacy of oral ketamine-midazolam combination and nitrous oxide-oxygen inhalation in children with Frankl behavior rating score 2 and ASA1.A total of 30 children were equally divided into 2 groups, oral midazolam-ketamine (MK) group which received 0.25mg/ kg midazolam with 3mg/kg ketamine in combination and the Nitrous oxide-oxygen (N) group which received nitrous oxide-oxygen inhalation. The parameters evaluated were the drug/ mask acceptance, need for the use of a physical restraint. Houpt's sedation scale, faces pain score, sedation duration, time taken to achieve the maximum sedation and adverse reactions were assessed. Student t-test was used for comparison between the groups and proportions were compared using Chi-square test.

Results: The results found no statistically significant differences between the groups in all the parameters except for the duration of sedation and the time taken to achieve maximum sedation which were higher in oral MK group than the Nitrous-oxide oxygen inhalation group.

Conclusion: Both oral-midazolam and ketamine combination and nitrous oxide-oxygen inhalation sedation were found to have similar clinical success among 3 to 10-year-old children in bringing about anxiolysis during dental treatment.

Clinical significance: Both oral ketamine-midazolam combination, nitrous oxide-oxygen inhalation are equally effective for anxiolysis in children during dental treatment.How to cite this article: Ilasrinivasan, Setty JV, Shyamachalam, Mendiretta P. A Comparative Evaluation of the Sedative Effects of Nitrous Oxide-oxygen Inhalation and Oral Midazolam-Ketamine Combination in Children. Int J Clin Pediatr Dent., 2018;11(5):399-405.

Keywords: Anxiolysis; Nitrous oxide-oxygen inhalation; Oral ketamine-midazolam combination; Sedative effects..

PubMed Disclaimer

Conflict of interest statement

Source of support: Nil Conflict of interest: None

References

    1. Wilson S. Pharmacological management of the pediatric dental patient. Pediatr Dent. 2004;26:131–136. - PubMed
    1. Peretz B. The use of sedation while treating pediatric dental patient in Isreal. Int. J. Pediatr. Dent. 2002;12:355–356. - PubMed
    1. Council O. Guideline on use of nitrous oxide for pediatric dental patients. Pediatr Dent. 2013;36(5):174–178. - PubMed
    1. Gronbaek AB, Svensson P, Vaeth M, Hansen I, Poulsen S. A placebo-controlled, double-blind, crossover trial on analgesic effect of nitrous oxide-oxygen inhalation. Int J Paediatr Dent. 2014;24(1):69–75. - PubMed
    1. Mohamed A, Daabiss , Mohamed H. Dexmedetomidine versus ketamine combined with midazolam;a comparison of anxiolytic and sedative premedication in chidlren. BJMP. 2011;4(4):441.

LinkOut - more resources