title: A Comparison of the Effectiveness of Oral Midazolam -N2O Versus Oral Ketamine - N2O in Pediatric Patients-An in-Vivo Study.
abstract: BACKGROUND
  Most children are casual and moderately agreeable in the dental treatment environment, however some of them show practices that upset the professional and make the protected conveyance of worthy treatment extremely troublesome. For such cases dental practitioner utilizes behavior management techniques. At the point when behavioral administration procedures come up short, some type of pharmacologic sedation or anesthesia may be an important and vital option. Dental sedation is a strategy in which the utilization of a medication or drugs produce(s) a condition of depression of the central sensory system empowering treatment to be completed during which verbal contact with the patient is kept up all through the time of sedation.
  
  
  OBJECTIVE
  This study was designed to evaluate and compare the effectiveness of oral midazolam and oral ketamine in combination with N2O-O2 in children undergoing dental treatment.
  
  
  METHODS
  This study involved a sample of 30 pediatric dental patients (age range is 3-9 years), whose selection criteria included ASA I & II health status, cooperative but apprehensive behavior and a need for multiple dental extractions. The patients were assigned to receive oral midazolam on their first visit and on the follow up visit they received oral ketamine. Nitrous oxide (30%) was used during each sedation visit. Physiological parameters like Respiratory Rate (RR), pulse rate, and oxygen saturation were evaluated for each procedure, followed by the use of modified Bender Visual Motor Gestalt Test to evaluate psychomotor effects. Data were analyzed using Independent sample student t -test.
  
  
  RESULTS
  Analysis of the data showed statistically no significant difference (p >0.05) on comparison of effectiveness of oral midazolam-N2O with oral ketamine-N2O when pulse rate, oxygen saturation and respiratory rate were taken into consideration. Psychomotor performance was found to be marginally better with oral midazolam-N2O compared to oral ketamine-N2O.
  
  
  CONCLUSIONS
  Both the drugs were effective in reducing the patient anxiety while undergoing dental extractions. Though the t-test results were not statistically significant with respect to physiological parameters. Oral midazolam-N2O showed marginally better results compared to oral ketamine-N2O with respect to psychomotor effects.
authors.affiliation: Reader, Department of Pedodontics and Preventive Dentistry, St. Joseph Dental College , Eluru, Andhra Pradesh, India .
authors.forename: Vasanthi
authors.initials: V
authors.lastname: Done
authors.affiliation: Professor and Head of the Department, Department of Pedodontics and Preventive Dentistry, Pinnamaneni Siddhartha Institute of Dental Sciences and Research , Gannavaram, Andhra Pradesh, India .
authors.forename: Ravichandrasekhar
authors.initials: R
authors.lastname: Kotha
authors.affiliation: Reader, Department of Pedodontics and Preventive Dentistry, St. Joseph Dental College , Eluru, Andhra Pradesh, India .
authors.forename: Aron Arun Kumar
authors.initials: AA
authors.lastname: Vasa
authors.affiliation: Reader, Department of Pedodontics and Preventive Dentistry, St. Joseph Dental College , Eluru, Andhra Pradesh, India .
authors.forename: Suzan
authors.initials: S
authors.lastname: Sahana
authors.affiliation: Senior Lecturer, Department of Pedodontics and Preventive Dentistry, St. Joseph Dental College , Eluru, Andhra Pradesh, India .
authors.forename: Raghavendra Kumar
authors.initials: RK
authors.lastname: Jadadoddi
authors.affiliation: Senior Lecturer, Department of Pedodontics and Preventive Dentistry, St. Joseph Dental College , Eluru, Andhra Pradesh, India .
authors.forename: Sushma
authors.initials: S
authors.lastname: Bezawada
keywords: Anxious pediatric patients; Conscious sedation; Dental procedures; Premedication