Isfahan University of Medical SciencesDental Research Journal1735-33279120120218Comparison of oral Midazolam-Ketamine and Midazolam-Promethazine as sedative agents in pediatric dentistry893893ENMojtaba VahidGolpayeganiDepartments of Pediatric Dentistry, Dental School, Shahid Beheshti Medical University, Tehran, Iran. mvahidg@yahoo.comFereshtehDehghanGhassemAnsariShahnazShayeghi20120218Background: Investigation was designed to evaluate the behavioral changes in children receivingdental treatment while they have been administered combination of Midazolam/Ketamine orMidazolam/Promethazine.Materials and Methods: This was a randomized double blind clinical trial with cases being selectedfrom those uncooperative children aged 2 to 6 years from those referred for treatment undergeneral anesthesia. Anxiety score of all cases were recorded before any attempt using Frankel’sanxiety scoring system with those in negative category being included. Cases with at least a pair ofsimilar size cavities on similar teeth were selected with each tooth being randomly allocated for onesedative regimen group. To avoid sequence effect, half of the patients received one regimen at thefirst visit while the other half received the other regimen as the first. Each case served as controlfor him or herself to reduce influencing factors. Child’s reaction was recorded before, during, andat the end of dental procedure. SO2 as well as Pulse rate were recorded as the most critical vitalsigns. Collected data were then analyzed using analysis of variance (ANOVA) and paired t-test.Results: Patients’ mean age was 3.5 years with 43% being male. Only 10% of the Ketamine/Midazolamgroup showed considerable amount of change in their behavior with a statistical significant differencebeing presented (P=0.029).Conclusion: Under the current circumstances, Ketamine/Midazolam combination providedsufficient sedative effect in lower doses. However, Midazolam/Promethazine combination did notproduce similar results.Key Words: Children, dental fear, ketamine, midazolam, oral sedation, promethazine