Comparative evaluation of intranasal midazolam-ketamine, dexmedetomidine-ketamine, midazolam-fentanyl, and dexmedetomidine-fentanyl combinations for procedural sedation and analgesia in pediatric dental patients: a randomized controlled trial
10.17245/jdapm.2023.23.2.69
- Author:
Abhilasha AGARWAL
1
;
Afroz Alam ANSARI
;
Rajendra NATH
;
Rakesh Kumar CHAK
;
Rajeev Kumar SINGH
;
Richa KHANNA
;
Prem Raj SINGH
Author Information
1. Department of Pediatric and Preventive dentistry, Faculty of Dental Sciences, King George Medical University, U.P., Lucknow, India
- Publication Type:Original Article
- From:Journal of Dental Anesthesia and Pain Medicine
2023;23(2):69-81
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:In order to assess the effectiveness of various analgesio-sedative combinations for pain relief and sedation in pediatric dental patients, a thorough evaluation of clinical studies and patient outcomes is necessary.
Methods:A total of 128 healthy, uncooperative pediatric dental patients were randomly allocated to receive one of the four combinations of drugs via the intranasal (IN) route: Group I received midazolam-ketamine (MK), Group II received dexmedetomidine-ketamine (DK), Group III received midazolam-fentanyl (MF), and Group IV received dexmedetomidine-fentanyl (DF) in a parallel-arm study design. The efficacy and safety of the combinations were evaluated using different parameters.
Results:The onset of sedation was significantly faster in the DF group than in the DK, MF, and MK groups (P < 0.001). The depth of sedation was significantly higher in the DK and DF groups than in the MK and MF groups (P < 0.01). DK and DF produced significant intra- and postoperative analgesia when compared with combinations of MK and MF. No significant adverse events were observed for any of the combinations.
Conclusions:The DK and DF groups showed potential as analgesio-sedatives in view of their anxiolytic and analgesic effects.
