Oral ketamine for deep sedation of difficult-to-manage children who are mentally handicapped: case report.

For a small subset of mentally handicapped individuals, the medical and dental setting can be so threatening that they react violently to health care providers. Deep sedation can be administered enterally using oral ketamine, 6-8 mg/kg, combined with glycopyrrolate mixed in simple syrup and preceded by a dose of an oral benzodiazepine and sodium citrate. A case utilizing this technique to sedate an extremely combative mentally handicapped female requiring dental treatment planning in an ambulatory surgical center is described. A review of this use of ketamine and caveats concerning its use are covered.