Table 1.
Characteristics of included studies
| Author/Year/Place | Sample size (M/F) | Age | Intervention/Dose (M) | Comparator/Dose (MK) | Ease of treatment completion/behavior of child during treatment | Sedation score | Onset of sedation | Recovery time | Adverse effects | Overall success |
|---|---|---|---|---|---|---|---|---|---|---|
| Koirala/200622/Nepal | 120 | 2–9 years | Midazolam: 0.5 mg/kg orally | Combination of midazolam 0.4 mg/kg and ketamine 3 mg/kg orally | MK: most convenient | MK: best sedation | MK: shortest time required | M: shortest | None | – |
| Bahetwar/201123/India | 45 (M: 22, F: 23) | 2–6 years | Midazolam: 0.3 mg/kg intranasally | MK (0.2 and 4 mg/kg, respectively) | M: 72% MK: 84% |
M: 84% MK: 89% |
M: 5–10 minutes MK: 4–10 minutes |
M: 26–40 minutes MK: 35–49 minutes |
Vomiting MK: 1 |
M: 69% MK: 84% |
| Moreira/201318/Brazil | 41 | Under 36 months | Oral midazolam (MS) at a dose of 1.0 mg⁄kg | MK [a combination of oral midazolam (0.5 mg⁄ kg) and ketamine (3 mg⁄ kg)] | OSUBRS score During dental exam PS: 12.5 ± 5.5 MS: 13.6 ± 4.5 MK: 12.6 ± 4.4 During treatment PS: 12.5 ± 5.2 MS: 14.0 ± 3.8 MK: 8.6 ± 4.1 |
MK: longer and effective session (p = 0.04) | – | – | Agitation MK: 1 Vomiting MK: 4 |
– |
| Antunes/201624/Brazil | 56 | Under 4 years | Moderate sedation with midazolam (dose 1 mg/kg, maximum 20 mg) administered orally | Moderate sedation with the association of midazolam (0.5 mg/kg, maximum 20 mg) and ketamine (3 mg/kg dose, maximum 50 mg) | OSUBRS score Quiet behavior M: 2.9 times MK: 4.3 times |
– | – | – | No adverse events | |
| Sado-Filho/201925/Brazil | 84 (M: 43, F: 41) |
Under 7 years | Oral midazolam (MO) (1.0 mg/kg, maximum 20.0 mg) | KMO: combination of ketamine (4.0 mg/kg, maximum 100.0 mg) and midazolam (0.5 mg/kg, maximum 5.0 mg) by oral route KMIN: combination of intranasal ketamine (4.0 mg/kg, maximum 100.0 mg) and midazolam (0.2 mg/kg, maximum 5.0 mg) |
OSUBRS score Quiet behavior MO: 10.7% KMO: 42.9% KMIN: 21.4% |
– | – | – | MO: 39% KMO: 53.6% KMIN: 39.3% |
MO: 32.1% KMO: 46.4% KMIN: 50.0% |