Evaluation of the sedative effect of intranasal versus intramuscular ketamine in 2-6-year-old uncooperative dental patients.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-01-01 DOI:10.17219/dmp/144364

Ghassem Ansari, Lida Toomarian, Tahereh Masoum, Shahnaz Shayeghi, Leila Eftekhar

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Abstract

Background: Conscious sedation has gained more popularity these days, with different routes of drug administration having various advantages and disadvantages. Among all, ketamine is one of the most commonly used drugs in children.

Objectives: The aim of the present study was to compare 2 different routes of ketamine administration - intranasal (IN) vs. intramuscular (IM) - in 2-6-year-old uncooperative children needing dental treatment.

Material and methods: This single-blind, crossover clinical trial was conducted on a group of 26 uncooperative children aged 2-6 years, who required at least 2 similar dental treatment visits. The patients were randomly assigned into 2 groups: group I - IN ketamine at their 1st session and IM ketamine at the 2nd session; and group II - exactly the opposite sequence. The sedative efficacy of the 2 techniques was assessed by 2 independent pediatric dentists based on the Houpt sedation rating scale. The data was analyzed using the Wilcoxon test, the repeated measures analysis of variance (ANOVA) and the least significant difference (LSD) test.

Results: The participants showed reduced crying and movement with improved sleepiness at the 3 time points examined when IM administration was performed as compared to IN sedation (p < 0.05). The overall behavior scores were higher for the IM route as compared to the IN route at all tested time points (p < 0.05). The operating dentist and the parents believed that the IM route was significantly more effective (p < 0.05). The children in the IN session reached equilibrium faster than those in the IM session (p < 0.05). No significant statistical differences were noted between the groups with regard to various physiological parameters investigated at different time intervals.

Conclusions: Intramuscular ketamine was more satisfactory and effective than the IN route when sedating uncooperative children for dentistry.

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在 2-6 岁不合作的牙科患者中评估鼻内氯胺酮与肌内氯胺酮的镇静效果。

背景：如今，意识镇静越来越受欢迎，不同的给药途径各有利弊。其中，氯胺酮是儿童最常用的药物之一：本研究旨在比较两种不同的氯胺酮给药途径--鼻内给药 (IN) 与肌内给药 (IM)--在需要接受牙科治疗的 2-6 岁不合作儿童中的应用情况：这项单盲交叉临床试验的对象是 26 名不合作的 2-6 岁儿童，他们至少需要接受两次类似的牙科治疗。患者被随机分为两组：第一组--第一次治疗时使用IN氯胺酮，第二次治疗时使用IM氯胺酮；第二组--顺序正好相反。两种技术的镇静效果由两名独立的儿童牙医根据霍普特镇静评分表进行评估。数据分析采用 Wilcoxon 检验、重复测量方差分析（ANOVA）和最小显著性差异（LSD）检验：结果：与 IN 镇静相比，在进行 IM 给药的 3 个时间点上，参试者的哭闹和活动减少，嗜睡情况有所改善（P < 0.05）。在所有测试时间点，IM 方式的总体行为评分均高于 IN 方式（P < 0.05）。手术牙医和家长都认为即时镇静的效果明显更好（p < 0.05）。使用 IN 方法的儿童比使用 IM 方法的儿童更快达到平衡状态（p < 0.05）。在不同时间间隔调查的各种生理参数方面，各组之间没有发现明显的统计学差异：结论：在对不合作的儿童进行牙科镇静时，肌肉注射氯胺酮比静脉注射氯胺酮的效果更理想、更有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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