Pain and anxiety management for pediatric dental procedures using various combinations of sedative drugs: A review

Giath Gazal, Wamiq Musheer Fareed, Muhammad Sohail Zafar, Khalid H Al-Samadani, Giath Gazal, Wamiq Musheer Fareed, Muhammad Sohail Zafar, Khalid H Al-Samadani

Abstract

For fearful and uncooperative children behavioral management techniques are used. In order to control the pain and anxiety in pedodontic patients, pharmacologic sedation, anesthesia and analgesia are commonly used. Midazolam is commonly used as an oral sedation agent in children; it has several features such as safety of use, quick onset and certain degree of amnesia that makes it a desirable sedation agent in children. This review paper discusses various aspects of oral midazolam, ketamine and their combinations in conscious sedation including, advantages of oral route of sedation, pharmacokinetics, range of oral doses, and antagonists for clinical dental treatment procedures.

Keywords: Ketamine; Oral midazolam; Pedodontics; Sedation in dentistry.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4908057/bin/fx1.jpg

References

    1. Adamowicz P., Kala M. Urinary excretion rates of ketamine and norketamine following therapeutic ketamine administration: method and detection window considerations. J. Anal. Toxicol. 2005;29:376–382.
    1. Adams D., Dervay K.R. Pharmacology of procedural sedation. AACN Adv. Crit. Care. 2012;23:349–354. (quiz 355–6)
    1. Agrawal D., Manzi S.F., Gupta R., Krauss B. Preprocedural fasting state and adverse events in children undergoing procedural sedation and analgesia in a pediatric emergency department. Ann. Emerg. Med. 2003;42:636–646.
    1. Al-Zahrani A., Wyne A., Sheta S. Comparison of oral midazolam with a combination of oral midazolam and nitrous oxide–oxygen inhalation in the effectiveness of dental sedation for young children. J. Indian Soc. Pedod. Prev. Dent. 2009;27:9–16.
    1. Beebe D.S., Belani K.G., Chang P., Hesse P.S., Schuh J.S., Liao J., Palahniuk R.J. Effectiveness of preoperative sedation with rectal midazolam, ketamine, or their combination in young children. Anesth. Analg. 1992;75:880–884.
    1. Butler T. Central and peripheral benzodiazepine receptors. Epilepsia. 2006;47:450–451.
    1. Chudnofsky C.R., Weber J.E., Stoyanoff P.J., Colone P.D., Wilkerson M.D., Hallinen D.L., Jaggi F.M., Boczar M.E., Perry M.A. A combination of midazolam and ketamine for procedural sedation and analgesia in adult emergency department patients. Acad. Emerg. Med. 2008;7:228–235.
    1. Curran H.V. Tranquillising memories: a review of the effects of benzodiazepines on human memory. Biol. Psychol. 1986;23:179–213.
    1. Dionne R. Oral midazolam syrup: a safer alternative for pediatric sedation. Compend. Contin. Educ. Dent. 1999;20 221–2, 225–8, 230.
    1. Erlandsson A., Bäckman B., Stenström A., Stecksén-Blicks C. Conscious sedation by oral administration of midazolam in paediatric dental treatment. Swed. Dent. J. 2001;25:97.
    1. Field L.M., Dorrance D.E., Krzeminska E.K., Barsoum L.Z. Effect of nitrous oxide on cerebral blood flow in normal humans. Br. J. Anaesth. 1993;70:154–159.
    1. Golpayegani M.V., Dehghan F., Ansari G., Shayeghi S. Comparison of oral midazolam–ketamine and midazolam–promethazine as sedative agents in pediatric dentistry. Dent. Res. J. 2012;9:36.
    1. Green S.M., Rothrock S.G., Lynch E.L., Ho M., Harris T., Hestdalen R., Hopkins G.A., Garrett W., Westcott K. Intramuscular ketamine for pediatric sedation in the emergency department: safety profile in 1022 cases. Ann. Emerg. Med. 1998;31:688–697.
    1. Green S.M., Rothrock S.G., Harris T., Hopkins G.A., Garrett W., Sherwin T. Intravenous ketamine for pediatric sedation in the emergency department: safety profile with 156 cases. Acad. Emerg. Med. 1998;5:971–976.
    1. Henry R.J., Jerrell R. Ambient nitrous oxide levels during pediatric sedations. Pediatr. Dent. 1990;12:87–91.
    1. Jensen B. Benzodiazepine sedation in paediatric dentistry. Swed. Dent. J. Suppl. 2002;153:1–45.
    1. Jensen B., Matsson L. Oral versus rectal midazolam as a pre-anaesthetic sedative in children receiving dental treatment under general anaesthesia. Acta Paediatr. 2002;91:920–925.
    1. Kain Z.N., Hofstadter M.B., Mayes L.C., Krivutza D.M., Alexander G., Wang S., Reznick J.S. Midazolam: effects on amnesia and anxiety in children. Anesthesiology. 2000;93:676–684.
    1. Karapinar B., Yilmaz D., Demirağ K., Kantar M. Sedation with intravenous ketamine and midazolam for painful procedures in children. Pediatr. Int. 2006;48:146–151.
    1. Kauffman R.E., Banner W., Berlin C., Blumer J., Gorman R., Lambert G., Wilson G., Bennett D., Cordero J., Cote C. Guidelines for monitoring and management of pediatric-patients during and after sedation for diagnostic and therapeutic procedures. Pediatrics. 1992;89:1110–1115.
    1. Khalid O., Srivastava R., Mulhall A., Paladugu A., Dryden G., Lippmann S. Conscious sedation: is it always needed for endoscopy? Pract. Gastroenterol. 2011;35:10–15.
    1. Koirala D.B., Pandey P.R.K., Saksen P.A.K., Kumar D.R., Sharma D.S. A comparative evaluation of newer sedatives in conscious sedation. J. Clin. Pediatr. Dent. 2006;30:273–276.
    1. Krauss B. Lippincott Williams & Wilkins; Philadelphia [u.a.]: 1999. Pediatric Procedural Sedation and Analgesia.
    1. Krauss B., Green S.M. Procedural sedation and analgesia in children. Lancet. 2006;367:766–780.
    1. Kupietzky A., Houpt M. Midazolam: a review of its use for conscious sedation in children. Pediatr. Dent. 1993;15:237.
    1. Lanza V., Mercadante S., Pignataro A. Effects of halothane, enflurane, and nitrous oxide on oxyhemoglobin affinity. Anesthesiology. 1988;68:591–594.
    1. Lindh-Stromberg U. Rectal administration of midazolam for conscious sedation of uncooperative children in need of dental treatment. Swed. Dent. J. 2001;25:105–111.
    1. Malinovsky J., Servin F., Cozian A., Lepage J., Pinaud M. Ketamine and norketamine plasma concentrations after iv, nasal and rectal administration in children. Br. J. Anaesth. 1996;77:203–207.
    1. Mistry R.B., Nahata M.C. Ketamine for conscious sedation in pediatric emergency care. Pharmacother. J. Human Pharmacol. Drug Ther. 2005;25:1104–1111.
    1. Nagdeve N., Yaddanapudi S., Pandav S. The effect of different doses of ketamine on intraocular pressure in anesthetized children. J. Pediatr. Ophthalmol. Strabismus. 2006;43:219.
    1. Nathan J.E., Vargas K. Oral midazolam with and without meperidine for management of the difficult young pediatric dental patient: a retrospective study. Pediatr. Dent. 2002;24:129–138.
    1. Okamoto G.U., Duperon D.F., Jedrychowski J.R. Clinical evaluation of the effects of ketamine sedation on pediatric dental patients. J. Clin. Pediatr. Dent. 1992;16:253–257.
    1. Parker R.I., Mahan R.A., Giugliano D., Parker M.M. Efficacy and safety of intravenous midazolam and ketamine as sedation for therapeutic and diagnostic procedures in children. Pediatrics. 1997;99:427–431.
    1. Roback M.G., Bajaj L., Wathen J.E., Bothner J. Preprocedural fasting and adverse events in procedural sedation and analgesia in a pediatric emergency department: are they related? Ann. Emerg. Med. 2004;44:454–459.
    1. Rodriguez E., Jordan R. Contemporary trends in pediatric sedation and analgesia. Emerg. Med. Clin. North Am. 2002;20:199.
    1. Roelofse J.A., Louw L.R., Roelofse P.G. A double blind randomized comparison of oral trimeprazine–methadone and ketamine–midazolam for sedation of pediatric dental patients for oral surgical procedures. Anesth. Prog. 1998;45:3.
    1. Sasada M.P., Smith S.P. Drugs in Anaesthesia and Intensive Care. Oxford University Press; Oxford: 1997.
    1. Sener S., Eken C., Schultz C.H., Serinken M., Ozsarac M. Ketamine with and without midazolam for emergency department sedation in adults: a randomized controlled trial. Ann. Emerg. Med. 2011;57(109–114):e2.
    1. Shende D., Darlong V., Asit N. Combination of oral ketamine and midazolam for preanaesthetic medication in pediatric patients: low dose vs high dose. Can. J. Anesth. 2003;50:27.
    1. Sievers T.D., Yee J.D., Foley M.E., Blanding P.J., Berde C.B. Midazolam for conscious sedation during pediatric oncology procedures: safety and recovery parameters. Pediatrics. 1991;88:1172–1179.
    1. Slonim A.D., Ognibene F.P. Sedation for pediatric procedures, using ketamine and midazolam, in a primarily adult intensive care unit: a retrospective evaluation. Crit. Care Med. 1998;26:1900–1904.
    1. Smith B.M., Cutilli B.J., Saunders W. Oral midazolam: pediatric conscious sedation. Compend. Contin. Educ. Dent. 1998;19:586–590.
    1. Tobias J.D., Phipps S., Smith B., Mulhern R.K. Oral ketamine premedication to alleviate the distress of invasive procedures in pediatric oncology patients. Pediatrics. 1992;90:537–541.
    1. Treston G. Prolonged pre-procedure fasting time is unnecessary when using titrated intravenous ketamine for paediatric procedural sedation. Emerg. Med. 2004;16:145–150.
    1. Warncke T., Stubhaug A., Jørum E. Ketamine, an NMDA receptor antagonist, suppresses spatial and temporal properties of burn-induced secondary hyperalgesia in man: a double-blind, cross-over comparison with morphine and placebo. Pain. 1997;72:99–106.
    1. Warner D., Cabaret J., Velling D. Ketamine plus midazolam, a most effective paediatric oral premedicant. Pediatr. Anesth. 2007;5:293–295.
    1. Webster L.R., Walker M.J. Safety and efficacy of prolonged outpatient ketamine infusions for neuropathic pain. Am. J .Ther. 2006;13:300–305.
    1. Wolf A., Doyle E., Thomas E. Modifying infant stress responses to major surgery: spinal vs extradural vs opioid analgesia. Pediatr. Anesth. 1998;8:305–311.
    1. Wylie, W.D., Churchill-Davidson, H.C., Healy, T.E.J., Cohen, P.J., 1995. Wylie and Churchill-Davidson’s A practice of anaesthesia, E. Arnold, Distributed in the Americas by Little, Brown, London; Boston, Boston, MA.
    1. Yanase H., Braham R.L., Fukuta O., Kurosu K. A study of the sedative effect of home-administered oral diazepam for the dental treatment of children. Int. J. Pediatr. Dent. 1996;6:13–17.
    1. Zsigmond E., Matsuki A., Kothary S., Jallad M. Arterial hypoxemia caused by intravenous ketamine. Anesth. Analg. 1976;55:311–314.

Source: PubMed

3
Se inscrever