title: Combination of oral ketamine and midazolam as a premedication for a severely autistic and combative patient.
abstract: 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.
authors.affiliation: Department of Pediatric Anesthesiology and Pain Medicine, Arkansas Children's Hospital, Little Rock, AR, 72202, USA.
authors.forename: Shailesh
authors.initials: S
authors.lastname: Shah
authors.forename: Sonia
authors.initials: S
authors.lastname: Shah
authors.forename: Jesus
authors.initials: J
authors.lastname: Apuya
authors.forename: Senthil
authors.initials: S
authors.lastname: Gopalakrishnan
authors.forename: Timothy
authors.initials: T
authors.lastname: Martin
mesh_terms: 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
chemical_list: D000778:Anesthetics, Dissociative; D006993:Hypnotics and Sedatives; D007649:Ketamine; D008874:Midazolam