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,
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( Hirayama Akira ) - Hirayama Dental Clinic
( Fukuda Ken-ichi ) - Tokyo Dental College Department of Oral Health and Clinical Science Division of Special Needs Dentistry and Orofacial Pain
( Koukita Yoshihiko ) - Tokyo Dental College Department of Dental Anesthesiology
( Ichinohe Tatsuya ) - Tokyo Dental College Department of Dental Anesthesiology
Abstract
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.
키워드
Dental Procedure; Intellectually Disabled Patients; Ketamine; Propofol; Vascular Pain
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