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- Title
Comparative evaluation of intranasal dexmedetomidine, intranasal midazolam, and nitrous oxide for conscious sedation of anxious children undergoing dental treatment: A randomized cross-over trial.
- Authors
Janiani, Palak; Gurunathan, Deepa; Manohar, Ramsesh
- Abstract
Background: Pharmacological methods, specifically sedatives, have gained popularity in managing the behavior of children during dental appointments. Aim: The aim of this study was to compare 1 μ/kg intranasal dexmedetomidine, 0.3 mg/kg intranasal midazolam, and nitrous oxide in evaluating the level of sedation, behavior of the child, onset of sedation, physiologic signs, and adverse effects. Materials and Methods: In this cross‑over trial, 15 children aged 6–8 years were randomized to receive intranasal atomized dexmedetomidine, intranasal atomized midazolam, and inhalation nitrous oxide at three separate visits. After administering the sedative agent, a single pulpectomy was performed during each appointment, and the outcomes were recorded. The washout period between each visit was 1 week. Results: All three sedative agents were equally effective in controlling overall behavior. Dexmedetomidine showed lower sedation level scores (agitated; score 9) than the other groups. There was a statistically significant difference in the onset of sedation, with dexmedetomidine having the longest onset of 36.2 ± 9.47 min. Coughing and sneezing were predominantly observed after administration of intranasal midazolam. Oxygen saturation levels were statistically lower in the intranasal midazolam group during local anesthesia administration and post‑treatment. Conclusion: 0.3 mg/kg intranasal midazolam is as effective as nitrous oxide sedation for controlling behavior and providing adequate sedation in pediatric dental patients. However, 1 μ/kg dexmedetomidine did not provide the same level of sedation and had a significantly longer onset. 0.3 mg/ kg intranasal midazolam is an effective alternative to nitrous oxide sedation in anxious children.
- Subjects
CONTROL (Psychology); INTRANASAL administration; NITROUS oxide; CHILD behavior; FEAR of dentists
- Publication
Journal of the Indian Society of Pedodontics & Preventive Dentistry, 2024, Vol 42, Issue 2, p141
- ISSN
0970-4388
- Publication type
Article
- DOI
10.4103/jisppd.jisppd_104_24