Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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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

  • Abhilasha Agarwal (Department of Pediatric and Preventive dentistry, Faculty of Dental Sciences, King George Medical University) ;
  • Afroz Alam Ansari (Department of Pediatric and Preventive dentistry, Faculty of Dental Sciences, King George Medical University) ;
  • Rajendra Nath (Department of Pharmacology & Therapeutics, King George Medical University) ;
  • Rakesh Kumar Chak (Department of Pediatric and Preventive dentistry, Faculty of Dental Sciences, King George Medical University) ;
  • Rajeev Kumar Singh (Department of Pediatric and Preventive dentistry, Faculty of Dental Sciences, King George Medical University) ;
  • Richa Khanna (Department of Pediatric and Preventive dentistry, Faculty of Dental Sciences, King George Medical University) ;
  • Prem Raj Singh (Department of Department of Anesthesiology and Critical Care, King George Medical University)
  • Received : 2022.09.20
  • Accepted : 2023.02.27
  • Published : 2023.04.01
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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.

Keywords

Acknowledgement

The authors are grateful to the staff members of the department where the study was conducted. We acknowledge the assistance and contribution of this project.

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