Oral Midazolam Evaluation

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“Comparative Evaluation of oral Midazolam, Oral Ketamine and Oral Midazolam-Ketamine combination as conscious sedative agents in Unco-operative pediatric dental patients”

Abstract
Introduction:
Pediatric dentists often encounter young, fearful and uncooperative patients. Managing anxious children in the operatory has always been a challenging task. Various aversive and non-aversive techniques have been employed to manage such patients. But these techniques cause a traumatic experience in the child’s mind leading to lifelong dental phobias and thereby instilling a negative attitude towards dentistry.
Conscious Sedation is a technique in which the use of a drug produces a state of depression of central nervous system enabling treatment to
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James et al compared combination of oral midazolam-Ketamine and oral trimeparazine- methadone and found to be more effective than the latter. Similarly Tina t al, compared Ketamine alone with Ketamine-promethazine and found that Ketamine yielded better sedation than the combination. Shabbier et al also conducted a study comparing oral midazolam and triclofos and found that oral midazolam was more effective in regulating patient behavior as compared to triclofos.
Ketamine, when used in lower doses, its acts as a conscious sedative agent. Ketamine, in its oral form undergoes first pass metabolism and is converted into nor Ketamine. This drug is easy to administer, has a rapid onset of action, there is a wide margin of safety and its exhibits short duration of action.
Midazolam is an imidazobenzodiazepine that can be given in the oral dose. It has a short half life of 1-2 hours; high potency and rapid onset of action. It has sedative, anxiolytic properties, provides ante grade amnesia, and also has anticonvulsant
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The combination is said to minimize the effects of delirium in children, reduce the cardiovascular sequel, provides longer working time and greater degree of amnesia. Thiago et al, compared the combination of midazolam and Ketamine in children as young as 36 months. They found that the combination provided more sedation as compared to midazolam alone and concluded that it was even effective in children for minor dental procedure.
The purpose of the present study was to evaluate the efficacy of oral midazolam, oral Ketamine and the combination of oral midazolam-Ketamine as conscious sedative agent in un-cooperative pediatric dental patient. Also record any variations in the vital statistics of the patient and any adverse caused due to the

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