J Korean Dent Soc Anesthesiol.  2012 Jun;12(2):111-114. 10.17245/jkdsa.2012.12.2.111.

Midazolam and Ketamine Intramuscular Premedication in Attention Deficit Hyperactivity Disorder Patient with Poor Cooperability

• Kim YJ
• Shin TJ
• Hyun HK
• Kim JW
• Jang KT
• Lee SH
• Kim CC
• Kim HJ
• Seo KS
• Lee JM
• Shin S

• KMID: 2345050
• DOI: http://doi.org/10.17245/jkdsa.2012.12.2.111

Abstract

Attention deficit hyperactivity disorder (ADHD) is characterized by inattention, impulsivity, and hyperactivity. Given high incidence of ADHD, many children with ADHD is likely to present for anesthesia. This case report suggests intramuscular premedication as an alternative method for anesthetic induction. A 9-year-old male patient with ADHD was transferred for dental treatment under general anesthesia. The patient refused to go into dental clinic office. Oral midazolam was given to the patient, however, he was resistant to take midazolam via oral route. Instead, we administer midazolam and ketamine via intramuscular route. After less than 10 miniutes, the patient became drowsy and was transferred to dental chair. Intravenous access and mask inhalation was possible. The patient received dental treatment under general anesthesia and recovered in a non-complicated way. In this case, intramuscular sedation with midazolam and ketamine was used as a premedication in highly uncoopearive patient refused to take oral sedative medication.

Keyword

Disabled patients; Midazolam; Ketamine; Attention Deficit Disorder with Hyperactivity

MeSH Terms

Anesthesia
Anesthesia, General
Attention Deficit Disorder with Hyperactivity*
Child
Dental Clinics
Humans
Impulsive Behavior
Incidence
Inhalation
Ketamine*
Male
Masks
Methods
Midazolam*
Premedication*
Ketamine
Midazolam