الفهرس 
AnxietyOnly 14 pages are availabe for public view
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Abstract
The field of pediatric dentistry beholds the greatest challenge among the other different branches of dentistry, in providing dental care without inflicting any adverse psychological impact upon the child. Uncooperative behavior represents the major problem in the dental setting, resulting in a delay or termination of the treatment before completion or a decrease in the quality of care provided, and is mostly attributed to behavioral manifestations of anxiety.
Today modern pediatric dentistry describes so many techniques to manage the behavior of the child. The use of range of drugs as adjuvant to behavioral psychology enables the dentist to handle most of the unmanageable children.
This study aimed to evaluate and compare the behavioral changes and sedative effects of either intravenous Ketofol or Dex in dental treatment of pediatric patients.
Twenty ASA I children, 5–10 years old, requiring dental pulp therapy, were referred from the Pediatric Dentistry department for sedation. They were randomly classified into two groups, group I; Ketofol (n=10) was given as 0.1 ml/kg loading dose over 10 min followed by 0.05-0.125 ml/kg/h continuous infusion, group II; Dexmedetomidine ( n=10) was given as 2 µg/kg loading dose over 10 min followed by 0.1-1 µg/kg/h continuous infusion. Behavior changes before, during and after treatment were evaluated. Oxygen saturation, respiratory rate, heart rate, mean arterial blood pressure were recorded every 5 min till discharge. The onset of sedation, treatment time, recovery time, discharge time and total time, the number of interruptions, total drug and rescue doses were measured. The incidence of any adverse effects and postoperative pain were recorded. Parents, Patients and dentist satisfaction were also evaluated.
The results of the current study showed that:
Both sedative techniques (Ketofol and Dex) can be used safely in the dental treatment of anxious pediatric patients reflected by hemodynamic stability, normal oxygen saturation and intact respiratory drive during sedation and recovery.
Both techniques showed better behavior changes during and after, compared to before, the procedure so decreasing the psychological impacts on the child. Also they showed similar analgesic effects in the early recovery period reflected by comfort scale without recording any adverse events with the given doses and infusion technique. Children, parents and dentists satisfaction were also observed in both techniques.
Ketofol showed rapid onset of sedation compared to Dex which was reflected by shorter duration required to achieve RSS ≥ 4.
Although Dex had comparable recovery time to Ketofol reflected by nearly similar return to MAS 10 but it showed rapid discharge time, shorter total treatment time, lower number of interruptions with lower rescue Propofol doses, and lower salivary secretions with more dentist satisfaction compared to Ketofol.