COMPARATIVE EVALUATION OF ONSET, DURATION AND SAFETY BETWEEN MIDAZOLAM, DEXMEDETOMIDINE SEDATION AND THEIR COMBINATION IN PRESCHOOLERS: A RANDOMIZED CLINICAL TRIAL | ||||
| Alexandria Dental Journal | ||||
| Article 8, Volume 46, Issue 1, April 2021, Page 185-192 PDF (286.14 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/adjalexu.2020.25527.1053 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Amira ElKhatib   1; Nadia Wahba 2; Karin Dowidar 3; Tamer Ahmed Maher Ghoneim4
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| 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. | ||||
| Keywords | ||||
| Midazolam; Dexmedetomidine; Moderate sedation; Dental sedation; Preschool children | ||||
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