Rectal administration of midazolam plus ketamine as conscious sedation for injured paediatric patients requiring Oral surgery

Abstract Objective Rectal sedation has been in use for many years in paediatric dentistry. The purpose of this study was to retrospectively investigate the incidence of rectal sedation with midazolam plus ketamine for oral minor surgery among paediatric patients in our department. Methods The incidence of rectal sedation for paediatric outpatients under the age 6 years requiring oral surgery of our department between January 2007 and December 2016 was retrospectively analysed. Rectal sedation was given to 10 paediatric patients (8 boys and 2 girls) and consisted of a 0.1 mg/kg dose of midazolam and a 5 mg/kg dose of ketamine. Results Every case was a traumatic injury, the most common region was the tongue, and the most frequent type of wound was a laceration. With respect to sedative effects, approximately 30 min after rectal administration of the two drugs, good anxiolysis and cooperation were obtained, and few adverse effects were seen in all 10 cases although there were some cases that were difficult to treat. Conclusions Rectal administration of midazolam plus ketamine provides a safe and reliable method for paediatric outpatients requiring an oral surgery procedure.