Sedación con Ketamina intravenosa versus Midazolam oral para pacientes menores de 15 años, con necesidades de atención odontológica especiales. Hospital Príncipe de Asturias, Córdoba, Argentina (2023)

Introduction: Disability, pediatric fear, and anxiety present barriers to dental treatment, as well as the need of sedation, with limited anesthesia availability in operating rooms. An interdisciplinary sedation protocol in a dental setting based on international recommendations could help address this issue. Both ketamine and midazolam have shown efficacy and safety in dental procedures. Objective: To determine the effectiveness of intravenous ketamine versus oral midazolam sedation in interdisciplinary pediatric dental clinic procedures at Principe de Asturias Hospital, Cordoba, Argentina (2023). Methodology: This was a descriptive, observational, retrospective, cross-sectional epidemiological study. Inclusion criteria: under 15 years old, Frankl definitely negative, ASA 1, and no difficult airway. Sedation protocols included oral Midazolam (M) and intravenous Ketamine (K). Means, standard deviations, frequencies, and percentages were calculated, and comparisons between groups were made using ANOV; Welch’s test, and ANCOVA were used to control covariates. Results: The study included 71 patients with an average age of 8.1 ± 2.9 years. Mild sedation (M) was used in 57.7% of cases. The main reason for sedation was fear and anxiety. The mean number of procedures per patient was significantly higher with ketamine (2.23 ± 1.35) compared to oral midazolam (1.27 ± 0.74) (p<0.001). Conclusion: In our study, ketamine, administered under pediatric supervision in an interdisciplinary setting, allowed a greater number of dental procedures per patient compared to oral midazolam.