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Effects of the addition of low-dose ketamine to propofol anesthesia in the dental procedure for intellectually disabled patients

BACKGROUND: This study aimed to examine whether the combination of low-dose ketamine and propofol in deep sedation is clinically useful in controlling the behavior in intellectually disabled patients who are typically extremely noncooperative during dental procedures. METHODS: A total of 107 extreme...

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Autores principales: Hirayama, Akira, Fukuda, Ken-ichi, Koukita, Yoshihiko, Ichinohe, Tatsuya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Dental Society of Anesthsiology 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6620539/
https://www.ncbi.nlm.nih.gov/pubmed/31338421
http://dx.doi.org/10.17245/jdapm.2019.19.3.151
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author Hirayama, Akira
Fukuda, Ken-ichi
Koukita, Yoshihiko
Ichinohe, Tatsuya
author_facet Hirayama, Akira
Fukuda, Ken-ichi
Koukita, Yoshihiko
Ichinohe, Tatsuya
author_sort Hirayama, Akira
collection PubMed
description BACKGROUND: This study aimed to examine whether the combination of low-dose ketamine and propofol in deep sedation is clinically useful in controlling the behavior in intellectually disabled patients who are typically extremely noncooperative during dental procedures. METHODS: A total of 107 extremely noncooperative intellectually disabled adult patients were analyzed. In all patients, deep sedation was performed using either propofol alone (group P) or using a combination of propofol and 0.2 mg/kg or 0.4 mg/kg ketamine (groups PK0.2 and PK0.4, respectively). The procedures were performed in the order of insertion of nasal cannula into the nostril, attachment of mouth gag, and mouth cleaning and scaling. The frequency of patient movement during the procedures, mean arterial pressure, heart rate, peripheral oxygen saturation, recovery time, discharge time, and postoperative nausea and vomiting were examined. RESULTS: The three groups were significantly different only in the frequency of patient movement upon stimulation during single intravenous injection of propofol and scaling. CONCLUSION: For propofol deep sedation, in contrast to intravenous injection of propofol alone, prior intravenous injection of low-dose ketamine (0.4 mg/kg) is clinically useful because it neither affects recovery, nor causes side effects and can suppress patient movement and vascular pain during procedures.
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spelling pubmed-66205392019-07-23 Effects of the addition of low-dose ketamine to propofol anesthesia in the dental procedure for intellectually disabled patients Hirayama, Akira Fukuda, Ken-ichi Koukita, Yoshihiko Ichinohe, Tatsuya J Dent Anesth Pain Med Original Article BACKGROUND: This study aimed to examine whether the combination of low-dose ketamine and propofol in deep sedation is clinically useful in controlling the behavior in intellectually disabled patients who are typically extremely noncooperative during dental procedures. METHODS: A total of 107 extremely noncooperative intellectually disabled adult patients were analyzed. In all patients, deep sedation was performed using either propofol alone (group P) or using a combination of propofol and 0.2 mg/kg or 0.4 mg/kg ketamine (groups PK0.2 and PK0.4, respectively). The procedures were performed in the order of insertion of nasal cannula into the nostril, attachment of mouth gag, and mouth cleaning and scaling. The frequency of patient movement during the procedures, mean arterial pressure, heart rate, peripheral oxygen saturation, recovery time, discharge time, and postoperative nausea and vomiting were examined. RESULTS: The three groups were significantly different only in the frequency of patient movement upon stimulation during single intravenous injection of propofol and scaling. CONCLUSION: For propofol deep sedation, in contrast to intravenous injection of propofol alone, prior intravenous injection of low-dose ketamine (0.4 mg/kg) is clinically useful because it neither affects recovery, nor causes side effects and can suppress patient movement and vascular pain during procedures. The Korean Dental Society of Anesthsiology 2019-06 2019-06-30 /pmc/articles/PMC6620539/ /pubmed/31338421 http://dx.doi.org/10.17245/jdapm.2019.19.3.151 Text en Copyright © 2019 Journal of Dental Anesthesia and Pain Medicine http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hirayama, Akira
Fukuda, Ken-ichi
Koukita, Yoshihiko
Ichinohe, Tatsuya
Effects of the addition of low-dose ketamine to propofol anesthesia in the dental procedure for intellectually disabled patients
title Effects of the addition of low-dose ketamine to propofol anesthesia in the dental procedure for intellectually disabled patients
title_full Effects of the addition of low-dose ketamine to propofol anesthesia in the dental procedure for intellectually disabled patients
title_fullStr Effects of the addition of low-dose ketamine to propofol anesthesia in the dental procedure for intellectually disabled patients
title_full_unstemmed Effects of the addition of low-dose ketamine to propofol anesthesia in the dental procedure for intellectually disabled patients
title_short Effects of the addition of low-dose ketamine to propofol anesthesia in the dental procedure for intellectually disabled patients
title_sort effects of the addition of low-dose ketamine to propofol anesthesia in the dental procedure for intellectually disabled patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6620539/
https://www.ncbi.nlm.nih.gov/pubmed/31338421
http://dx.doi.org/10.17245/jdapm.2019.19.3.151
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