Evaluation of the effects of sedative agents used in different concentrations on anxiety in pediatric patients

ABSTRACT Evaluation Of The Effects Of Sedative Agents Used In Different Concentrations On Anxiety In Pediatric Patients Purpose: The aims of this study were to evaluate the changes in the anxiety level after deep sedation with various intravenous sedative agents using salivary cortisol level in pediatric dental patients and to compare clinical effectiveness of this sedative agents, perioperative complications, recovery time and adverse effects. Material and Method: This clinical study was included 69 healthy pediatric patients aged 3 to 7 years with high anxiety. The patients were divided into 3 groups according to the sedative agents: Group 1 (23 patient) was received Propofol, Group 2 (23 patient) was receieved Ketofol 1:3, and Group 3 (23 patient) was received Ketofol 1:4. The anxiety levels were assessed using FIS anxiety scale and changes in salivary cortisol levels were assessed before and after the drug administration. Perioperative vital signs, depth of sedation were recorded at intervals of 5 minutes. Preoperative and postoperative complications and recovery time were recorded in the follow-up form. SPSS 23.0 package program was used for the statistical analysis of the data. Results: The projective scale FIS showed insignificant alteration in the post-treatment dental anxiety levels of the children compared with the pre-treatment anxiety levels (p≥0,05). Additionally, there were increases in saliva cortisol levels of Group 2 (p=0,000) and Group 3 (p=0,003) after treatments performed under sedation. Although, it was not found significant differences between all groups in terms of vital signs, depth of sedation, operation time, postperative complications (p≥0,05); there were significant differences in perioperative complications. It was found that prevalence of the pain of local anaesthesia injection in Group 1 (p=0,025) and decrease in saturation in Group 3 (p=0,05) were differance is statistically significant higher than the other groups in the perioperative period. When the recovery times were compared, it was found that the recovery time of the patients in Group 2 were statistically significantly longer than of the patients in Group 1 (p=0,000) and Group 3 (p=0,001). Conclusion: Based on our study, the infusion of propofol and ketofol mixtures (1:3 and 1:4) provided an effective sedation without any serious complications in dental sedation. It was concluded that ketofol mixtures could increase the anxiety level of pediatric dental patients compare with propofol infusion. Key Words: Anxiety, Deep Sedation, Ketofol, Propofol, Salivary Cortisol