A comparison of two oral ketamine-diazepam regimens for the sedation of anxious pediatric dental patients.
OBJECTIVE
This study compared 2 oral ketamine-diazepam regimens (8 mg/kg and 10 mg/kg of ketamine in combination with 0.1 mg/kg diazepam) in preschool age children with respect to physiological, behavioral and amnestic parameters.


METHODS
Twenty-five children completed the double-blind, crossover design. Physiologic, behavioral and amnestic effects were evaluated.


RESULTS
ANOVA demonstrated significant changes in systolic blood pressures and heart rates in both the 8 mg/kg group and 10 mg/kg group (P < 0.05), as well as significant changes in diastolic blood pressures in the 10 mg/kg group (P < 0.05). However, these changes were not clinically significant. Success rates were 28% for the 8 mg/kg dosage and 44% for the 10 mg/kg dosage. There was a cumulative vomiting rate of 50% and a psychic phenomena rate of 10%. There were no statistically significant differences between the two dosages with regard to success rates, postoperative vomiting, or psychic phenomena using McNemar's test.


CONCLUSIONS
There is no advantage of 10 mg/kg dose of ketamine over the 8 mg/kg dose. Ketamine did not demonstrate amnestic effects in this study. There were statistically but no clinically significant changes in physiological parameters in either group. This study does not support the use of either 8 mg/kg or 10 mg/kg oral ketamine for the sedation of uncooperative children.
Sullivan
D C
DC
Baylor College of Dentistry, Texas A&M University System Health Science Center, Dallas, Texas, USA.
Wilson
C F
CF
Webb
M D
MD
D000284:Administration, Oral; D000704:Analysis of Variance; D000766:Anesthesia, Dental; D000779:Anesthetics, Local / Q000008:administration & dosage; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002652:Child Behavior / Q000187:drug effects; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods*; D003299:Cooperative Behavior; D018592:Cross-Over Studies; D003448:Crying; D016854:Dental Anxiety / Q000517:prevention & control*; D003793:Dental Restoration, Permanent; D003975:Diazepam / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D018691:Excitatory Amino Acid Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage / Q000627:therapeutic use*; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D011939:Mental Recall / Q000187:drug effects; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D014839:Vomiting / Q000139:chemically induced
D000779:Anesthetics, Local; D014151:Anti-Anxiety Agents; D004338:Drug Combinations; D018691:Excitatory Amino Acid Antagonists; D007649:Ketamine; D008012:Lidocaine; D003975:Diazepam