M N Wood1, M C G Manley2, N Bezzina3, R Hassan4. 1. Deceased, late of Leagrave Dental Sedation Clinic, 696 Dunstable Road, Luton, LU4 8SE. 2. The Royal Hospital for Neuro-disability, West Hill, Putney, London, SW15 3SW. 3. Dental Clinic 15 Naxxar Road, Birkirkara, BKR 9049 Malta. 4. Leagrave Dental Sedation Clinic, 696 Dunstable Road, Luton, LU4 8SE.
Abstract
AIM: An audit of the use of intravenous ketamine for the provision of conscious sedation in paediatric dentistry was carried out over a three-year period. AUDIT DESIGN: In the audit, 3,751 children were treated and an evaluation was carried out for safety and effectiveness of the drug and procedure, the quality of sedation and clinical procedures provided. In addition, the occurrence of any adverse effects and parental satisfaction were noted along with recovery. All children were ASA I and II, with an average age of 7.5 years. Children were referred because of management problems and were assessed to be at the high anxious level of four and five on the Venham scale. A weight related 0.25 mg/kg was initially administered with additional increments of 0.25 mg/kg given if required. The average total dose provided was 0.41 mg/kg. RESULTS: The majority of children (76%) accepted all treatment with no problems, with 19% experiencing a small amount of resistance. Although a range of dental treatment was provided, it was mostly exodontias of carious primary dentition. A 27% response was provided assessing satisfaction which was very favourable. No adverse reactions occurred although the most common postoperative experience was nausea. CONCLUSION: This audit demonstrated the safety and effectiveness of using intravenous ketamine for paediatric conscious sedation and implications for training and appropriate service delivery were discussed.
AIM: An audit of the use of intravenous ketamine for the provision of conscious sedation in paediatric dentistry was carried out over a three-year period. AUDIT DESIGN: In the audit, 3,751 children were treated and an evaluation was carried out for safety and effectiveness of the drug and procedure, the quality of sedation and clinical procedures provided. In addition, the occurrence of any adverse effects and parental satisfaction were noted along with recovery. All children were ASA I and II, with an average age of 7.5 years. Children were referred because of management problems and were assessed to be at the high anxious level of four and five on the Venham scale. A weight related 0.25 mg/kg was initially administered with additional increments of 0.25 mg/kg given if required. The average total dose provided was 0.41 mg/kg. RESULTS: The majority of children (76%) accepted all treatment with no problems, with 19% experiencing a small amount of resistance. Although a range of dental treatment was provided, it was mostly exodontias of carious primary dentition. A 27% response was provided assessing satisfaction which was very favourable. No adverse reactions occurred although the most common postoperative experience was nausea. CONCLUSION: This audit demonstrated the safety and effectiveness of using intravenous ketamine for paediatric conscious sedation and implications for training and appropriate service delivery were discussed.