A Comparative Evaluation of the Sedative Effects of Nitrous Oxide-oxygen Inhalation and Oral Midazolam-Ketamine Combination in Children

AIMS: To compare nitrous oxide-oxygen inhalation and low dose oral midazolam-ketamine combination for anxiolysis in the management of children aged between 3 to 10 years for dental treatment. MATERIALS AND METHODS: A comparative clinical study with equal number of subjects in both the groups evaluating efficacy of oral ketamine-midazolam combination and nitrous oxide-oxygen inhalation in children with Frankl behavior rating score 2 and ASA1. A total of 30 children were equally divided into 2 groups, oral midazolam-ketamine (MK) group which received 0.25mg/ kg midazolam with 3mg/kg ketamine in combination and the Nitrous oxide-oxygen (N) group which received nitrous oxide-oxygen inhalation. The parameters evaluated were the drug/ mask acceptance, need for the use of a physical restraint. Houpt’s sedation scale, faces pain score, sedation duration, time taken to achieve the maximum sedation and adverse reactions were assessed. Student t-test was used for comparison between the groups and proportions were compared using Chi-square test. RESULTS: The results found no statistically significant differences between the groups in all the parameters except for the duration of sedation and the time taken to achieve maximum sedation which were higher in oral MK group than the Nitrous-oxide oxygen inhalation group. CONCLUSION: Both oral-midazolam and ketamine combination and nitrous oxide-oxygen inhalation sedation were found to have similar clinical success among 3 to 10-year-old children in bringing about anxiolysis during dental treatment. CLINICAL SIGNIFICANCE: Both oral ketamine-midazolam combination, nitrous oxide-oxygen inhalation are equally effective for anxiolysis in children during dental treatment. How to cite this article: Ilasrinivasan, Setty JV, Shyamachalam, Mendiretta P. A Comparative Evaluation of the Sedative Effects of Nitrous Oxide-oxygen Inhalation and Oral Midazolam-Ketamine Combination in Children. Int J Clin Pediatr Dent., 2018;11(5):399-405.