Folayan M O, Faponle A F, Oziegbe E O, Adetoye A O
Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
Department of Anaesthesia, Obafemi Awolowo University, Ile-Ife.
Eur J Paediatr Dent. 2014 Jun;15(2):132-6.
The need to manage children using safe, effective and inexpensive conscious sedation materials and techniques in paediatric dentistry is high. This study evaluated the safety and effectiveness of a combination of low dose ketamine (5 mg/kg) and diazepam (0.2 mg/kg) used for conscious sedation in healthy children undergoing paediatric dental procedures at a paediatric dental outpatient clinic over a 3-year period.
All children who were scheduled for conscious sedation between 2009 and 2012 were included in the study. All children received ketamine 5 mg/kg body weight in combination with diazepam 0.2 mg/kg body weight in a single oral dose for use as conscious sedation. Patients were considered sedated when the Ramsey Score was 2 or 3. Time of onset and duration of surgical procedures were recorded. Side effects during and after discharge were recorded.
Twenty five patients participated in the study. The effectiveness of the sedation was 84.0%. The mean time of onset of action was 10.5 ± 7.2 minutes. All cases that needed additional sedation needed this after 35?36 minutes. Three cases (12.0%) developed high temperature in the night of the day of the procedure. There was a case (4.0%) of hallucination.
Ketamine and diazepam as medication for conscious sedation was considered effective. The duration of effectiveness appears to be 35 minutes. The combination is considered safe for use for conscious sedation in healthy paediatric dental outpatients undergoing minor oral surgical procedures.
在儿童牙科中，使用安全、有效且廉价的清醒镇静材料和技术来治疗儿童的需求很高。本研究评估了低剂量氯胺酮（5毫克/千克）和地西泮（0.2毫克/千克）联合用于一家儿童牙科门诊在3年期间对接受儿童牙科手术的健康儿童进行清醒镇静的安全性和有效性。
纳入2009年至2012年期间计划接受清醒镇静的所有儿童。所有儿童均接受单次口服剂量为5毫克/千克体重的氯胺酮与0.2毫克/千克体重的地西泮联合使用作为清醒镇静。当拉姆齐评分达到2或3分时，患者被视为处于镇静状态。记录手术开始时间和持续时间。记录术中及出院后的副作用。
25名患者参与了该研究。镇静有效率为84.0%。平均起效时间为10.5±7.2分钟。所有需要额外镇静的病例均在35至36分钟后需要。3例（12.0%）在手术当天夜间出现高热。有1例（4.0%）出现幻觉。
氯胺酮和地西泮作为清醒镇静药物被认为是有效的。有效持续时间似乎为35分钟。该联合用药被认为对于接受小型口腔外科手术的健康儿童牙科门诊患者进行清醒镇静是安全的。
