Anestesia e Pesquisa Clínica
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Premedication with Nasal Sedation as an Aid for Behaviour Management in Dental Procedures for Children

Aktham Shoukry, Assem Moharram, Osama Shahawy, Abla Aly, Heba Morgan and Fayrouz Soliman

Background: In recent times major advancements in techniques, technologies and materials have resulted in benefits in the everyday clinical practice of dentistry, despite these gains, anxiety related to dental treatments in children is a problem suffered by many patients worldwide, and it remains a significant challenge in providing dental care.

Patients and methods: One hundred children, aged 5-8 years, presenting for simple extraction procedures were selected to participate in the study and randomly divided into two groups (50 patients each).

Control group (the C group): were treated by conventional treatment (nonpharmacological behavior management) while sedation group (the S group) were premeditated by intranasal sedation (3 mg/kg Ketamine and 0.5 mg/kg Midazolam) .Perioperative sedative effects, pain, anxiety level changes were assessed, also Time of procedural were recorded.

Results: Children premeditated with intranasal sedation (S group) achieved significantly lowersedation levels (P=0.042), pain score (p=0.032), lower anxiety levels (P=0.036), and easier child-parent separation (P=0.029) than C group also, The S group showed decrease in the mean of the total time of procedural 20 minute ± 3.7 versus 25 min ± 2.8 in C group and this decrease was statistically significant in comparison with the C group (P<0.05 ).

Conclusion: Intranasal sedation using ketamine and midazolam was associated with lower sedation levels, lower anxiety levels, and easier child-parent separation at the time of transferring patients to the operating room than children who were not sedated. Moreover the time needed to perform a simple extraction under intranasal sedation is significantly less than that of regular chair side procedure, which suggests possible balanced cost benefit.