ElKhatib, A., Wahba, N., Dowidar, K., Ghoneim, T. (2021). COMPARATIVE EVALUATION OF ONSET, DURATION AND SAFETY BETWEEN MIDAZOLAM, DEXMEDETOMIDINE SEDATION AND THEIR COMBINATION IN PRESCHOOLERS: A RANDOMIZED CLINICAL TRIAL. Alexandria Dental Journal, 46(Issue 1), 185-192. doi: 10.21608/adjalexu.2020.25527.1053
Amira ElKhatib; Nadia Wahba; Karin Dowidar; Tamer Ahmed Maher Ghoneim. "COMPARATIVE EVALUATION OF ONSET, DURATION AND SAFETY BETWEEN MIDAZOLAM, DEXMEDETOMIDINE SEDATION AND THEIR COMBINATION IN PRESCHOOLERS: A RANDOMIZED CLINICAL TRIAL". Alexandria Dental Journal, 46, Issue 1, 2021, 185-192. doi: 10.21608/adjalexu.2020.25527.1053
ElKhatib, A., Wahba, N., Dowidar, K., Ghoneim, T. (2021). 'COMPARATIVE EVALUATION OF ONSET, DURATION AND SAFETY BETWEEN MIDAZOLAM, DEXMEDETOMIDINE SEDATION AND THEIR COMBINATION IN PRESCHOOLERS: A RANDOMIZED CLINICAL TRIAL', Alexandria Dental Journal, 46(Issue 1), pp. 185-192. doi: 10.21608/adjalexu.2020.25527.1053
ElKhatib, A., Wahba, N., Dowidar, K., Ghoneim, T. COMPARATIVE EVALUATION OF ONSET, DURATION AND SAFETY BETWEEN MIDAZOLAM, DEXMEDETOMIDINE SEDATION AND THEIR COMBINATION IN PRESCHOOLERS: A RANDOMIZED CLINICAL TRIAL. Alexandria Dental Journal, 2021; 46(Issue 1): 185-192. doi: 10.21608/adjalexu.2020.25527.1053
COMPARATIVE EVALUATION OF ONSET, DURATION AND SAFETY BETWEEN MIDAZOLAM, DEXMEDETOMIDINE SEDATION AND THEIR COMBINATION IN PRESCHOOLERS: A RANDOMIZED CLINICAL TRIAL
1Assisstant lecturer, Department of Pediatric Dentistry, Faculty of Dentistry, Kafrelsheikh University
2Professor, Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Egypt
3Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University
4Department of Anesthesia and Intensive care, Faculty of Medicine, Alexandria University.
Abstract
Introduction: Dental anxiety is a global problem in pediatric dentistry. Moderate sedation is an acceptable option for uncooperative preschoolers dental patients. Objective: To compare midazolam (MDZ), dexmedetomidine (DEX) and their combination (DEX/MDZ) as sedative drugs for preschoolers undergoing dental treatment regarding onset, duration and safety of sedation. Materials and methods: The study was a three-arm randomized clinical trial with a parallel design. Seventy-two healthy uncooperative preschoolers were selected from the Faculty of Dentistry, Alexandria University, Egypt. The participants were randomly allocated into, control group received 0.5mg/kg MDZ, study group I received 5µg/kg DEX, and study group II received 0.3mg/kg MDZ followed by 3µg/kg DEX. Each child received quadrant treatment. Time until optimum sedation and recovery were recorded. Vital signs were recorded throughout the treatment session. Results: All children were comparable regarding demography, physical status and baseline vital signs (blood pressure, heart rate, and oxygen saturation). There was a statistically significant difference regarding onset and duration of the effect of sedative drugs (P=<0.001). Dexmedetomidine had the most delayed onset of action (17.08 ± 5.88 min), while DEX/ MDZ had the longest duration of action (68.13 ± 17.12). There was a significant decrease in blood pressure throughout the sedation session for all children. Children who were sedated with DEX and DEX/MDZ had a significant decrease in heart rate than children sedated with MDZ. No statistically significant effect of drugs on oxygen saturation levels was recorded. Conclusion: Midazolam, Dexmedetomidine and their combination are safe drugs during moderate sedation for children undergoing dental treatment.
Zanaty OM, El Metainy SA. A comparative evaluation of nebulized dexmedetomidine, nebulized ketamine, and their combination as premedication for outpatient pediatric dental surgery. Anesth Analg. 2015;121:167-71.
Gupta A MC, Bhatia HP, Dahiya V. Behaviour management of an anxious child. Stomatologija. 2014;16:3-6.
Silva CC LC, Areias C, Moura ̃ o J, Andrade D. . Conscious sedation vs general anesthesia in pediatric dentistry – a
review. MedicalExpress (São Paulo, online). . 2015;2:M150104. Doi.org/10.5935/MedicalExpress.2015.01.04
AAoPD. CAC-BMS. Guideline on Behavior Guidance for the Pediatric Dental Patient. Pediatr Dent. 2015 37:57-70.
Barends CR AA, van Minnen B, Vissink A, Visser A. Dexmedetomidine versus Midazolam in Procedural Sedation. A
Systematic Review of Efficacy and Safety. PLoS One. 2017;12:e0169525. DOI: 10.1371/journal.pone.0169525
Ghajari MF AG, Hasanbeygi L, Shayeghi S. Conscious Sedation Efficacy of 0.3 and 0.5 mg/kg Oral Midazolam for Three to Six Year-Old Uncooperative Children Undergoing Dental Treatment: A Clinical Trial. J Dent (Tehran).
2016;13:101-7.
Ghai B JK, Saxena AK, Bhatia N, Sodhi KS. Comparison of oral midazolam with intranasal dexmedetomidine
premedication for children undergoing CT imaging: a randomized, double-blind, and controlled study. Paediatr
Anaesth. 2017;27:37-44.
Weerink MAS SM, Hannivoort LN, Barends CRM, Absalom AR, Colin P. Clinical Pharmacokinetics and
Pharmacodynamics of Dexmedetomidine. Clin Pharmacokinet. 2017;56:893-913.
Singh C, Pandey RK, Saksena AK, Chandra G. A comparative evaluation of analgo-sedative effects of oral
dexmedetomidine and ketamine: a triple-blind, randomized study. Paediatr Anaesth. 2014;24:1252-9.
Bagheri M. The Use of Midazolam in Paediatric Dentistry: A Review of the Literature. Razavi Int J Med.
Moher D HS, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG. BMJ
2010;340:c869Research Methods and Reporting: CONSORT 2010 Explanation and Elaboration: updated guidelines
for reporting parallel group randomised trials. BMJ 2010;340:c869. 2010.
Faul F, Erdfelder, E., Lang, A.-G., & Buchner, A. . G*Power 3: A flexible statistical power analysis program for the
social, behavioral, and biomedical sciences. Behavior Research Methods. 2007;39:175-91.
ASA Physical Status Classification System. Available at: https://www.asahq.org/resources/clinical- information/asa-physical-status-classification-system. American Society of Anesthesiologists. Accessed on 20
JUN 2018.
Singh H RR, Kadtane S, Dalai DR, Jain CD. Techniques for the Behavior Management in Pediatric Dentistry. Int J Sci
Stud 2014;2:269-72.
Frankl SN SF, Fozels HR. Should the parent remain with the child in the dental operatory? . J Dent Child
1962;29:150-63.
Gomes HS MA, Viana KA, Batista AC, Costa PS, Daher A, Machado GC,, Sado-Filho J VL, Corrêa-Faria P, Hosey MT,
Costa LR. Intranasal sedation using ketamine and midazolam for pediatric dental treatment (NASO): study protocol
for a randomized controlled trial. Trials. 2017;18:172. Doi: 10.1186/s13063-017-1919-2
Guideline for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic
and Therapeutic Procedures: Update 2016. Pediatr Dent. 2016;15:77-106.
Jambure N NA. Comparison of Intranasal dexmedetomidine and oral midazolam as premedication for cardiac catheterization procedure in pediatric patients. Anaesth Pain & Intensive Care. 2016;20(Suppl 1:S48-S52).Doi: 10.4103/aer.AER_119_17
Greaves A. The use of Midazolam as an Intranasal Sedative in Dentistry. SAAD Dig. 2016;32:46-9.
Dean J, Jones, J., Vinson, L. and McDonald, R. Saxen A. pharmacological behaviour managment. McDonald and
Avery's dentistry for the child and adolescent. St. Louis, Missouri: Elsevier. 2016:303-27.
for sedation in children administered either by atomiser or by drops. Anaesthesia. 2016;71:522-8.
Mohite V, Baliga S, Thosar N, Rathi N. Role of dexmedetomidine in pediatric dental sedation. J Dent Anesth Pain
Med. 2019;19:83-90.
Cozzi G ML, Maximova N, Poropat F, Magnolato A, Sbisà E, Norbedo S,, Sternissa G ZD, Barbi E. Combination of
intranasal dexmedetomidine and oral midazolam as sedation for pediatric MRI. Paediatr Anaesth. 2017;27:976-7.
Surendar MN, Pandey RK, Saksena AK, Kumar R, Chandra G. A comparative evaluation of intranasal dexmedetomidine, midazolam and ketamine for their sedative and analgesic properties: a triple blind randomized
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