IV sedation in pediatric dentistry: an alternative to general anesthesia

This prospective study was conducted to determine the sedative effects of IV ketamine and fentanyl on vital signs and behavior. Twenty-seven children, classified as ASA I, with a mean age of 34 months, were studied. The dosages of IV ketamine and fentanyl given were 0.5 mg/kg and 0.5 mcg/kg, respectively, approximately every 15-20 min. The pulse rate averaged 125 throughout the case. Blood pressure averaged 112/64. The respiration rate averaged 22 breaths per min. Mean behavior composite scores were 1.9 at the initial examination and 3.3 during treatment. One child vomited during treatment. Post-treatment complications were discomfort in 19% (5), nausea in 22% (6), and vomiting in 15% (4) of the patients. We concluded that IV sedation of precooperative healthy pediatric patients with ketamine, fentanyl, and nitrous oxide/oxygen appears to be a safe and effective sedation modality with minimal side effects when administered and monitored by a qualified anesthetist, offering the practitioner an alternative to general anesthesia.