IV sedation in pediatric dentistry: an alternative to general anesthesia.
This prospective study was conducted to determine the sedative effects of IV ketamine and fentanyl on vital signs and behavior. Twenty-seven children, classified as ASA I, with a mean age of 34 months, were studied. The dosages of IV ketamine and fentanyl given were 0.5 mg/kg and 0.5 mcg/kg, respectively, approximately every 15-20 min. The pulse rate averaged 125 throughout the case. Blood pressure averaged 112/64. The respiration rate averaged 22 breaths per min. Mean behavior composite scores were 1.9 at the initial examination and 3.3 during treatment. One child vomited during treatment. Post-treatment complications were discomfort in 19% (5), nausea in 22% (6), and vomiting in 15% (4) of the patients. We concluded that IV sedation of precooperative healthy pediatric patients with ketamine, fentanyl, and nitrous oxide/oxygen appears to be a safe and effective sedation modality with minimal side effects when administered and monitored by a qualified anesthetist, offering the practitioner an alternative to general anesthesia.
Barr
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EB
Department of Pharmacology, Baltimore College of Dental Surgery, University of Maryland.
Wynn
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RL
D000766:Anesthesia, Dental / Q000379:methods*; D000771:Anesthesia, Intravenous; D001794:Blood Pressure / Q000187:drug effects; D002652:Child Behavior / Q000187:drug effects*; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods*; D004338:Drug Combinations; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D006919:Hydroxyzine / Q000008:administration & dosage / Q000494:pharmacology; D007223:Infant; D007649:Ketamine / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D009609:Nitrous Oxide / Q000008:administration & dosage; D011446:Prospective Studies; D011674:Pulse / Q000187:drug effects; D012119:Respiration / Q000187:drug effects
D004338:Drug Combinations; D006919:Hydroxyzine; D007649:Ketamine; D009609:Nitrous Oxide; D005283:Fentanyl