| Summary: | This study was designed to evaluate the efficacy and safety of intranasal sufentanil/midazolam [S/M] and ketamine/madazolam [K/M] for sedation and analgesia in preschool children that require dental surgery [extractions].<br />
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Fifty children [ASA 1] aged 5 &ndash === 7 years, requiring six or more dental extractions under general anaesthesia, were allocated to two groups of 25 children to receive either ketamine 5 mg/kg or sufentanil 20&mu === g intranasally, 20 minutes before induction of surgery in this randomised double-blind study. All the children in both groups in addition concurrently received nasal midazolam 0,3 mg/kg. For induction of anaesthesia, sevoflurane in nitrous oxide and oxygen, was used.<br />
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S/M was accepted significantly better as a nasal pre-medication [p< === 0.05]. Both groups were equally sedated and a smooth mask induction of anaesthesia was experienced in the majority of children. Recovery of children in both groups were similar === 82% of the S/M group were fully recovered 120 minutes post-operatively versus 80% in the K/M group [p> === 0,05]. Effective postoperative analgesia for multiple extractions was provided. For pain evaluation, children were divided into two groups, a non-responder group where all pain values over time were more than 40 and a responder group where pain values were equal to, or less than 40. Seventy two percent of children in the S/M group were responders as to fifty two percent in the K/M group [p> === 0,05]. No adverse respiratory, cardiovascular or other effects were recorded. This study showed that intranasal administration of sufentanil /midazolam or ketamine/midazolam, provides safe and effective sedation and analgesia in children aged 5&ndash === 7 years undergoing multiple dental extractions.
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