An evaluation of ketamine hydrochloride for use in pedodontic out-patients

Abstract

The need for a safe but effective agent to sedate dental patients who are severe behavior management problems prompted this investigation of ketamine HCl. Ketamine HCl is a general anesthetic agent with the unique property of selectively depressing the higher centers of the brain without adversely affecting respiration or cardiac output. Sixty behavior problem pedodontic patients were selected at random and placed in one of three groups to receive the following treatments: Treatment I - ketamine HCl and scopolamine; Treatment II - ketamine, scopolamine, and droperidol, and Treatment III - ketamine, scopolamine, and nitrous oxide-oxygen analgesia. Each treatment group received ketamine HCl 2 mg/lb and 0.1 - 0.3 mg scopolamine. The second two treatment groups were supplemented with droperidol .025 mg/lb or nitrous oxide-oxygen (20-50%) to maintain anesthesia. The patients were given a series of pre and post-treatment mental and physical tests and were considered completely recovered when they could equal their pre treatment test scores. Routine dental restorative procedures limited to one and one-half hours were carried out with the use of the ruber dam. Onset of anesthesia was five minutes for all three treatment groups. Treatment III showed a significantly longer working time but recovery times were not significantly different between groups. Ketamine HCl was determined to be a safe, effective agent for use in pedodontic outpatients provided prescribed techniques are followed. Complications were infrequent and minor and parental response was considered satisfactory.