Effects of midazolam/low-dose ketamine conscious intravenous sedation on pain, swelling, and trismus after surgical extraction of third molars.

Abstract

PURPOSE:

To assess the clinical efficacy of midazolam plus low-dose ketamine conscious intravenous sedation on relief from or prevention of postoperative pain, swelling, and trismus after the surgical extraction of third molars.

PATIENTS AND METHODS:

Patients admitted for surgical extraction of mandibular third molars (n = 50) were included. All patients received an initial dose of 0.03 mg/kg intravenous midazolam; then patients in the midazolam-placebo (MP) group received 2 mL of a placebo IV, while patients in the midazolam-ketamine (MK) group received 2 mL of a ketamine + saline combination (0.3 mg/kg ketamine + saline) IV.

RESULTS:

Facial swelling on postoperative days was significantly lower in the MK group than in the MP group (P = .001). Mouth opening on postoperative days was significantly greater in the MK group than in the MP group (P = .001). Pain scores measured on a visual analog scale at 4, 12, and 24 hours after surgery were significantly higher in the MP group than in the MK group (P = .001).

CONCLUSIONS:

Conscious intravenous sedation with midazolam/low-dose ketamine during surgical extraction of third molars can provide the patient with a comfortable procedure and good postoperative analgesia, with less swelling and significantly less trismus. Intravenous low-dose ketamine may be safe and effective in reducing postoperative pain.

• Authors: Hasan Garip, Tülin Satılmış, Gühan Dergin, Faysal Uğurlu, Kamil Göker
• Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (J Oral Maxillofac Surg) Vol. 69 Issue 4 Pg. 1023-30 (Apr 2011) ISSN: 1531-5053 [Electronic] United States
• PMID: 21216077 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anesthetics, Dissociative
• Anesthetics, Intravenous
• Anesthetics, Local
• Hypnotics and Sedatives
• Placebos
• Ketamine
• Carticaine
• Midazolam

Topics

• Adult
• Anesthetics, Dissociative (administration & dosage)
• Anesthetics, Intravenous (administration & dosage)
• Anesthetics, Local (administration & dosage)
• Carticaine (administration & dosage)
• Conscious Sedation
• Edema (prevention & control)
• Female
• Follow-Up Studies
• Humans
• Hypnotics and Sedatives (administration & dosage)
• Ketamine (administration & dosage)
• Male
• Mandible (surgery)
• Midazolam (administration & dosage)
• Molar, Third (surgery)
• Mouth (drug effects)
• Pain Measurement
• Pain, Postoperative (prevention & control)
• Patient Satisfaction
• Placebos
• Postoperative Complications (prevention & control)
• Safety
• Time Factors
• Tooth Extraction
• Treatment Outcome
• Trismus (prevention & control)
• Young Adult