• Journal of anesthesia · Jan 2009

    Case Reports

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

    • Shailesh Shah, Sonia Shah, Jesus Apuya, Senthil Gopalakrishnan, and Timothy Martin.
    • Department of Pediatric Anesthesiology and Pain Medicine, Arkansas Children's Hospital, Little Rock, AR, 72202, USA.
    • J Anesth. 2009 Jan 1; 23 (1): 126-8.

    AbstractPatients 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.

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