title: A double blind randomized trial of ketofol versus propofol for endodontic treatment of anxious pediatric patients.
abstract: OBJECTIVE
  To find out the safe and efficient sedative agent for primary molar pulpectomy in uncooperative pediatric patients.
  
  
  METHODS
  This double blind randomized trial enrolled 40 anxious and healthy 2-6 year olds. All subjects received IV propofol (1-1.5 mg/kg) or ketofol (1-1.5 mg/kg propofol with 0.25 mg/kg ketamine) as per group assignment after oral midazolam premedication (0.5 mg/kg). Sedation maintenance was done with propofol infusion at 25-75 microg/kg/min titrated to a predefined Worse level as per Houpt's sedation rating scale. Additional bolus/es was/were administered in the dosage similar to induction dose in case of inadequate sedation. Primary outcomes were intraoperative and postoperative adverse events. Secondary outcomes were vital signs, success of procedure, operator satisfaction, sedation quality, treatment time, recovery time and total propofol dose.
  
  
  RESULTS
  Significantly greater incidence of respiratory depression was reported for ketofol group (11/20; 55%) when compared to propofol group (3/20; 15%) (p = 0.008). Desaturation was the most common adverse respiratory event with significantly greater incidence in ketofol group (9/20; 45%) when compared to propofol only group (3/20; 15%) (p = 0.033). No significant differences regarding secondary outcomes were reported in two groups.
  
  
  CONCLUSIONS
  Both the regimen exhibited similar sedation profile while propofol alone emerged as a safer option.
authors.affiliation: Department of Pedodontics and Preventive Dentistry, Santosh Dental College and Hospital, Ghaziabad, Uttar Pradesh, India. dr.neetipgi@gmail.com
authors.forename: N
authors.initials: N
authors.lastname: Mittal
authors.forename: A
authors.initials: A
authors.lastname: Goyal
authors.forename: K
authors.initials: K
authors.lastname: Gauba
authors.forename: A
authors.initials: A
authors.lastname: Kapur
authors.forename: K
authors.initials: K
authors.lastname: Jain
mesh_terms: D002648:Child; D002675:Child, Preschool; D016854:Dental Anxiety / Q000188:drug therapy*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D007649:Ketamine / Q000009:adverse effects*; D008297:Male; D008874:Midazolam / Q000627:therapeutic use; D015742:Propofol / Q000009:adverse effects*; D011670:Pulpectomy; D012131:Respiratory Insufficiency / Q000139:chemically induced*
chemical_list: D004338:Drug Combinations; D006993:Hypnotics and Sedatives; D007649:Ketamine; D008874:Midazolam; D015742:Propofol