Clinical Report

Journal of Anesthesia

, Volume 23, Issue 1, pp 126-128

Combination of oral ketamine and midazolam as a premedication for a severely autistic and combative patient

  • Shailesh ShahAffiliated withDepartment of Pediatric Anesthesiology and Pain Medicine, Arkansas Children’s Hospital
  • , Sonia ShahAffiliated withDepartment of Pediatric Anesthesiology and Pain Medicine, Arkansas Children’s Hospital
  • , Jesus ApuyaAffiliated withDepartment of Pediatric Anesthesiology and Pain Medicine, Arkansas Children’s Hospital
  • , Senthil GopalakrishnanAffiliated withDepartment of Pediatric Anesthesiology and Pain Medicine, Arkansas Children’s Hospital
  • , Timothy MartinAffiliated withDepartment of Pediatric Anesthesiology and Pain Medicine, Arkansas Children’s Hospital

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Patients with impaired ability to understand and communicate can be difficult to manage perioperatively. They frequently require lateral thinking on the part of the anesthesiologists to make the induction process as smooth as possible. We present a case of a severely autistic and violent patient scheduled for dental rehabilitation under general anesthesia. A combination of oral ketamine and midazolam was mixed in the beverage Dr Pepper to mask the taste and the appearance of the drugs. The unique flavor of Dr Pepper is well suited to increase the palatibility and the acceptability of medications in children and patients with developmental delay.

Key words

Premedication Oral ketamine Oral midazolam Autistic patient