title: Outpatient sedation: an essential addition to gynecologic care for persons with mental retardation.
abstract: Routine gynecologic care for persons with mental retardation may be difficult to provide, especially to those women who do not allow a pelvic examination to be performed. Of 275 women referred to a multidisciplinary clinic addressing the reproductive health concerns of mentally retarded women, 61 patients (22%) did not allow a gynecologic examination to be performed. The administration of ketamine alone, midazolam alone, or a combination of midazolam and ketamine allowed for the successful performance of a gynecologic examination in 81% of previously uncooperative women. No adverse effects of the medications were noted. We conclude that sedation of difficult-to-examine, mentally handicapped women can be safely performed in the outpatient setting, thus avoiding the need for general anesthesia and its inherent risks.
authors.affiliation: Department of Anesthesia, Pediatrics and Communicable Disease, University of Michigan Medical Center, Ann Arbor 48109-0718.
authors.forename: D A
authors.initials: DA
authors.lastname: Rosen
authors.forename: K R
authors.initials: KR
authors.lastname: Rosen
authors.forename: T E
authors.initials: TE
authors.lastname: Elkins
authors.forename: H F
authors.initials: HF
authors.lastname: Andersen
authors.forename: S G
authors.initials: SG
authors.lastname: McNeeley
authors.forename: C
authors.initials: C
authors.lastname: Sorg
mesh_terms: D000553:Ambulatory Care; D005260:Female; D006176:Gynecology; D006801:Humans; D006993:Hypnotics and Sedatives; D008607:Intellectual Disability / Q000523:psychology*; D010808:Physical Examination
chemical_list: D006993:Hypnotics and Sedatives