Ege University, Faculty of Medicine, Anestesiology Department, Izmir, Turkey.
Eur J Paediatr Dent. 2010 Mar;11(1):19-22.
We compared the efficacy of sedation with oral Midazolam and a combination of oral Midazolam and Ketamine, used as alternatives to general anaesthesia during tooth extraction.
Retrospective study.
A total of 30 patients aged between 3 and 9 years, who had elective tooth extraction were included in the study. Subjects in Group A (n. 15) were given 0.75 mg/kg Midazolam orally while those in Group B (n. 15) were given 0.75 mg/kg Midazolam orally+5 mg/kg ketamine. Acceptance of orally administered drugs, sedation and anxiety scores and reactions to local anaesthetic injection and tooth extraction were assessed.
Sedation and anxiety scores in Group B were better than in Group A (p<0.05). Reactions to local anaesthetic injection and tooth extraction were very significantly less common in Group B (p<0.0001). Requirement for an additional medication was more common in Group A (p<0.05). Side effects were not observed in either group.
Patient demographics and time to discharge were analysed by Mann-Whitney U test, whereas Chi-square test was used to analyse compliance to sedation, anxiety and sedation scores, reaction to tooth extraction, side effects and additional drug requirement.
Compared to oral Midazolam only, a combination of oral Midazolam+Ketamine resulted in better sedation and surgical comfort in children during a painful procedure such as tooth extraction.
我们比较了在拔牙过程中，使用口服咪达唑仑与口服咪达唑仑联合氯胺酮作为全身麻醉替代药物的镇静效果。
回顾性研究。
共纳入 30 名 3 至 9 岁接受择期拔牙的患者。A 组（n=15）患者口服 0.75mg/kg 咪达唑仑，B 组（n=15）患者口服 0.75mg/kg 咪达唑仑+5mg/kg 氯胺酮。评估口服药物的接受情况、镇静和焦虑评分以及对局部麻醉注射和拔牙的反应。
B 组的镇静和焦虑评分优于 A 组（p<0.05）。B 组对局部麻醉注射和拔牙的反应明显较少（p<0.0001）。A 组需要额外药物的情况更常见（p<0.05）。两组均未观察到副作用。
患者人口统计学和出院时间采用曼-惠特尼 U 检验分析，而对镇静、焦虑和镇静评分、对拔牙的反应、副作用和额外药物需求的依从性采用卡方检验分析。
与单独口服咪达唑仑相比，口服咪达唑仑联合氯胺酮在儿童进行疼痛性操作（如拔牙）时可提供更好的镇静和手术舒适度。
