title: Effects of midazolam/low-dose ketamine conscious intravenous sedation on pain, swelling, and trismus after surgical extraction of third molars.
abstract: OBJECTIVE
  To assess the clinical efficacy of midazolam plus low-dose ketamine conscious intravenous sedation on relief from or prevention of postoperative pain, swelling, and trismus after the surgical extraction of third molars.
  
  
  METHODS
  Patients admitted for surgical extraction of mandibular third molars (n = 50) were included. All patients received an initial dose of 0.03 mg/kg intravenous midazolam; then patients in the midazolam-placebo (MP) group received 2 mL of a placebo IV, while patients in the midazolam-ketamine (MK) group received 2 mL of a ketamine + saline combination (0.3 mg/kg ketamine + saline) IV.
  
  
  RESULTS
  Facial swelling on postoperative days was significantly lower in the MK group than in the MP group (P = .001). Mouth opening on postoperative days was significantly greater in the MK group than in the MP group (P = .001). Pain scores measured on a visual analog scale at 4, 12, and 24 hours after surgery were significantly higher in the MP group than in the MK group (P = .001).
  
  
  CONCLUSIONS
  Conscious intravenous sedation with midazolam/low-dose ketamine during surgical extraction of third molars can provide the patient with a comfortable procedure and good postoperative analgesia, with less swelling and significantly less trismus. Intravenous low-dose ketamine may be safe and effective in reducing postoperative pain.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Marmara University, Istanbul, Marmara, Turkey. hasangarip@yahoo.com
authors.forename: Hasan
authors.initials: H
authors.lastname: Garip
authors.forename: Tülin
authors.initials: T
authors.lastname: Satılmış
authors.forename: Gühan
authors.initials: G
authors.lastname: Dergin
authors.forename: Faysal
authors.initials: F
authors.lastname: Uğurlu
authors.forename: Kamil
authors.initials: K
authors.lastname: Göker
mesh_terms: D000328:Adult; D000778:Anesthetics, Dissociative / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002355:Carticaine / Q000008:administration & dosage; D016292:Procedural Sedation; D004487:Edema / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D008334:Mandible / Q000601:surgery; D008874:Midazolam / Q000008:administration & dosage*; D008964:Molar, Third / Q000601:surgery*; D009055:Mouth / Q000187:drug effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D010919:Placebos; D011183:Postoperative Complications / Q000517:prevention & control*; D012449:Safety; D013997:Time Factors; D014081:Tooth Extraction; D016896:Treatment Outcome; D014313:Trismus / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D010919:Placebos; D007649:Ketamine; D002355:Carticaine; D008874:Midazolam