In: Health18 Nov 2009
The age range of the subjects was 21-43 months, with a mean age of 33V2 months. There were no significant differences in age (for controls, range, 21-43 months; mean, 33 months; for experimental patients, range, 25-43 months; mean, 34 months) (Table 3). Under the conditions of this study, the average time in the operatory, from placement onto the Papoose Board until treatment completion, was not significantly different between the 2 groups using the Student’s t test at P = .05 (Table 3). In the control group (ketamine only), 3 (27%) of 11 patients vomited. The first patient had one episode of vomiting during the treatment procedure and once when she left the office. The second patient vomited once when he left the office. The third patient vomited once approximately 15 minutes after receiving the ketamine. These patients vomited varying small amounts of clear liquids. In the experimental group (ketamine and promethazine), none of the subjects experienced vomiting (0%). A 2 X 2 chi-square contingency table showed that there was a statistically significant difference in the vomiting frequencies between the 2 drug regimens at P <. 05.
For both groups, most of the patients drank the liquids willingly and tolerated the taste quite well. Four of the patients refused any oral intake and were administered the premedication using a Monoject syringe. Also, in both groups most of the patients were drowsy or asleep and exhibited no crying or movement at 25 minutes when they were separated from the parents. For the local anesthetic administration, approximately half of the control and half of the experimental subjects did not cry, whereas the other half exhibited intermittent to strong
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|Variable||Experimental Group (n =11)||Control Group (n = 11)|
|Age, mean ± SD||34 ± 6.28||33 ± 6.65|
|Sex||Males = females||Males = females|
|Time in operatory, mean ± SD||33 ± 11.87||30 ± 6.12|
|Vomiting, No. (%)||0(0)||3(27)|
|General behavior score, mean ± SD||3.12 ± 0.29||4.27 ± 0.5|
crying. Most remained drowsy and about half of the patients were awake. There was an increase in body movement, however, in more than half of the patients, and the movement was rated by the anesthesiologist observer as controllable and not interfering with the local anesthetic administration. At the initiation of treatment, more patients were crying in the experimental group than in the control group. In both groups, most of the patients were drowsy and only a few were fully awake. A greater number of patients exhibited continuous movement in the experimental group than in the control group.
The control group yielded more effective sedations than those seen in the experimental group. There were more control patients rated in the good and very good categories, whereas the experimental patients were more distributed in the fair and good categories (Table 3). Each group yielded one excellent sedation. Of the total participants, only one case (experimental group) was aborted due to the patient’s violent physical movement and crying, rendering the treatment impossible. The patient was rescheduled to have the dental treatment performed under general anesthesia. The difference in the general behavior between the 2 groups was statistically significant as demonstrated by the Mann-Whitney U test at P = .05. The pulse and blood pressure measurements were within a normal range from baseline for each patient. Oxygen saturation levels were maintained between 97-100%. One patient had a transient drop of the oxygen saturation from 99-95% halfway through the treatment, but it quickly returned to 97%. There were no clinically significant differences in saliva production between the experimental group and the control group and no other apparent adverse effects on either patient group as a whole.
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