Combination of oral ketamine and midazolam as a premedication for a severely autistic and combative patient.
Patients with impaired ability to understand and communicate can be difficult to manage perioperatively. They frequently require lateral thinking on the part of the anesthesiologists to make the induction process as smooth as possible. We present a case of a severely autistic and violent patient scheduled for dental rehabilitation under general anesthesia. A combination of oral ketamine and midazolam was mixed in the beverage Dr Pepper to mask the taste and the appearance of the drugs. The unique flavor of Dr Pepper is well suited to increase the palatibility and the acceptability of medications in children and patients with developmental delay.
Shah
Shailesh
S
Department of Pediatric Anesthesiology and Pain Medicine, Arkansas Children's Hospital, Little Rock, AR, 72202, USA.
Shah
Sonia
S
Apuya
Jesus
J
Gopalakrishnan
Senthil
S
Martin
Timothy
T
D000328:Adult; D000768:Anesthesia, General; D000778:Anesthetics, Dissociative / Q000008:administration & dosage; D001321:Autistic Disorder / Q000150:complications* / Q000523:psychology; D001628:Beverages; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007649:Ketamine / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D019647:Oral Surgical Procedures; D011229:Preanesthetic Medication; D014754:Violence
D000778:Anesthetics, Dissociative; D006993:Hypnotics and Sedatives; D007649:Ketamine; D008874:Midazolam