پیوندهای مفید
آمار
| تعداد نشریات | 20 |
| تعداد شماره‌ها | 1,183 |
| تعداد مقالات | 10,793 |
| تعداد مشاهده مقاله | 72,655,633 |
| تعداد دریافت فایل اصل مقاله | 12,778,845 |
Comparison of two Intranasal Sedatives, Midazolam versus Dexmedetomidine, in Children with High Dental Fear: a Randomized Clinical Trial | ||
| Journal of Dentistry | ||
| مقاله 8، دوره 23، شماره 2 - شماره پیاپی 75، 2022، صفحه 129-136 اصل مقاله (498.87 K) | ||
| نوع مقاله: Original Article | ||
| شناسه دیجیتال (DOI): 10.30476/dentjods.2021.89323.1406 | ||
| نویسندگان | ||
| Katayoun Salem* 1؛ Hossein Khoshrang2؛ Elham Esmaeeli3؛ Mona Vatankhah4 | ||
| 1Dept. of Pediatric Dentistry, Faculty of Dentistry, Tehran Medical Sciences, Azad University Tehran, Iran. Dept. of Pediatric Dentistry, Guilan Dental school, Guilan University of Medical Sciences, Rasht, Iran. | ||
| 2Dept. of Anesthesia, Guilan Medical School, Guilan University of Medical Sciences, Rasht, Iran. | ||
| 3Dentist, Guilan Dental School, Guilan University of Medical Sciences, Rasht, Iran. | ||
| 4Pediatric Dentist, Dept. of Pediatric Dentistry, Faculty of Dentistry, Tehran Medical Sciences, Azad University Tehran, Iran. | ||
| چکیده | ||
| Statement of the Problem: Pharmacologic management of uncooperative behavior is a growing trend in dentistry. Determining the most appropriate drug, route of administration, and proper candidate for sedation have been the goal of several investigations. Purpose: The aim of this study was to compare the sedative effect of intranasal (IN) sedation of midazolam (MDZ) in compare to dexmedetomidine (DEX) while taking into consideration the effect of dental fear, and psychological status on sedation success. Materials and Method: This double-blind randomized clinical trial included 92 uncooperative dental patients aged 4-6. Study participants were randomly assigned to receive either 0.2mg/kg IN MDZ or 1µg/kg DEX. Sedation was evaluated using the Houpt sedation rating scale. Vital signs were recorded before and during sedation. Prior to sedation, the level of dental fear was determined through children's fear survey schedule-dental subscale (CFSS-DS). Psychological characteristics were screened using the strengths and difficulties questionnaire (SDQ). Data were analyzed using T-test, Mann-Whitney, Chi-square, and repeated-measures analysis of variance (ANOVA). Results: Overall ratings of sedation and subscales of sleep, crying, and movement were comparable between groups (p> 0.05); however, more acceptable behavior (overall scores (4+5+6) was observed in MDZ group compared to DEX group (64% vs. 47.7%) (p= 0.007). All participants were found to have abnormal levels of dental fear (CFSS-DS≥38). However, according to SDQ, the study participants have mainly shown normal behavioral status. A significant association was found between dental fear and sedation success (MDZ, p= 0.001, DEX, p= 0.03), while similar findings were not observed for psychological characteristics (MDZ, p= 0.09 and p= 0.41; DEX, p= 0.71 and p= 0.53). Physiological parameters remained within normal limits in both groups. Conclusion: Sedation with IN MDZ resulted in overall behaviors, which were more satisfactory in highly fearful pediatric dental patients. Despite baseline uncooperative behaviors, the psychological status of study participants were close to average and were not associated with sedation failure. | ||
| کلیدواژه‌ها | ||
| Dental fear؛ Dexmedetomidine؛ IN sedation؛ Midazolam | ||
|
سایر فایل های مرتبط با مقاله
|
||
| مراجع | ||
|
[1] Neville DN, Hayes KR, Ivan Y, McDowell ER, Pitetti RD. Double-blind randomized controlled trial of intranasal dexmedetomidine versus intranasal midazolam as anxiolysis prior to pediatric laceration repair in the emergency department. Acad Emerg Med. 2016; 23: 910-917.
[2] Mohite V, Baliga S, Thosar N, Rathi N. Role of dexmedetomidine in pediatric dental sedation. J Dent Anesth Pain Med. 2019; 19: 83-90.
[3] Akin A, Bayram A, Esmaoglu A, Tosun Z, Aksu R, Altuntas R, et al. Dexmedetomidine vs midazolam for premedication of pediatric patients undergoing anesthesia. Paediatr Anaesth. 2012; 22: 871-876.
[4] AlSarheed MA. Intranasal sedatives in pediatric dentistry. Saudi Med J. 2016; 37: 948-956.
[5] Loggia ML, Schweinhardt P, Villemure C, Bushnell MC. Effects of psychological state on pain perception in the dental environment. J Can Dent Assoc. 2008; 74: 651-656.
[6] Peng K, Wu SR, Ji FH, Li J. Premedication with dexmedetomidine in pediatric patients: a systematic review and meta-analysis. Clinics (Sao Paulo). 2014; 69: 777-786.
[7] Lewis J, Bailey CR. Intranasal dexmedetomidine for sedation in children; a review. J Perioper Pract. 2020; 30: 170-175.
[8] Attri JP, Sharan R, Makkar V, Gupta KK, Khetarpal R, Kataria AP. Conscious Sedation: Emerging Trends in Pediatric Dentistry. Anesth Essays Res. 2017; 11: 277-281.
[9] Kain ZN, MacLaren J, McClain BC, Saadat H, Wang SM, Mayes LC, et al. Effects of age and emotionality on the effectiveness of midazolam administered preoperatively to children. Anesthesiology. 2007; 107: 545-552.
[10] Finley GA, Stewart SH, Buffett-Jerrott S, Wright KD, Millington D. High levels of impulsivity may contraindicate midazolam premedication in children. Can J Anaesth. 2006; 53: 73-78.
[11] Isik B, Baygin O, Kapci EG, Bodur H. The effects of temperament and behavior problems on sedation failure in anxious children after midazolam premedication. Eur J Anaesthesiol. 2010; 27: 336-340.
[12] Ghali AM, Mahfouz AK, Al-Bahrani M. Preanesthetic medication in children: a comparison of intranasal dexmedetomidine versus oral midazolam. Saudi J Anaesth. 2011; 5: 387-391.
[13] Ghasem*Pour M, Haji*Ahmadi M, Pourya*Vali M. Dental experiments induced anxiety in 6-12 year old children and relative factors. J Babol Univ Med Scien. 2004; 6: 12-16.
[14] Shahrivar Z, Tehrani-Doost M, Pakbaz B, Rezaie A, Ahmadi F. Normative data and psychometric properties of the parent and teacher versions of the strengths and difficulties questionnaire (SDQ) in an Iranian community sample. J Res Med Sci. 2009; 14: 69-77.
[15] Houpt MI, Weiss NJ, Koenigsberg SR, Desjardins PJ. Comparison of chloral hydrate with and without promethazine in the sedation of young children. Pediatr Dent. 1985; 7: 41-46.
[16] Sheta SA, Al-Sarheed MA, Abdelhalim AA. Intranasal dexmedetomidine vs midazolam for premedication in children undergoing complete dental rehabilitation: a double-blinded randomized controlled trial. Paediatr Anaesth. 2014; 24: 181-189.
[17] 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 study. J Clin Pediatr Dent. 2014; 38: 255-261.
[18] Malhotra P, Thakur S, Singhal P, Chauhan D, Jayam C, Sood R, et al. Comparative evaluation of dexmedetomidine and midazolam-ketamine combination as sedative agents in pediatric dentistry: A double-blinded randomized controlled trial. Contem Clin Dent. 2016; 7: 186-192.
[19] Talon MD, Woodson LC, Sherwood ER, Aarsland A, McRae L, Benham T. Intranasal dexmedetomidine premedication is comparable with midazolam in burn children undergoing reconstructive surgery. J Burn Care Res. 2009; 30: 599-605.
[20] Akimoto T, Hashimoto S, Sunada K. Dexmedetomidine (12.5 mug/mL) improves tissue distribution, anesthetic action, and hemodynamic effects of lidocaine after palatal infiltration in rats. Odontology. 2016; 104: 390-396.
[21] Weerink MAS, Struys M, Hannivoort LN, Barends CRM, Absalom AR, Colin P. Clinical Pharmacokinetics and Pharmacodynamics of Dexmedetomidine. Clin Pharmacokinet. 2017; 56: 893-913.
[22] Hitt JM, Corcoran T, Michienzi K, Creighton P, Heard C. An evaluation of intranasal sufentanil and dexmedetomidine for pediatric dental sedation. Pharmaceutics. 2014; 6: 175-184.
[23] Barends CR, Absalom A, 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.
[24] Cozzi G, Norbedo S, Barbi E. Intranasal Dexmedetomidine for Procedural Sedation in Children, a Suitable Alternative to Chloral Hydrate. Paediatr Drugs. 2017; 19: 107-111.
[25] Wilson S. Chloral hydrate and its effects on multiple physiological parameters in young children: a dose-response study. Pediatr Dent. 1992; 14: 171-177.
[26] Erten H, Akarslan ZZ, Bodrumlu E. Dental fear and anxiety levels of patients attending a dental clinic. Quintessence Int. 2006; 37: 304-310.
[27] Nooh N, Sheta SA, Abdullah WA, Abdelhalim AA. Intranasal atomized dexmedetomidine for sedation during third molar extraction. Int J Oral Maxillofac Surg. 2013; 42: 857-862. | ||
|
آمار تعداد مشاهده مقاله: 2,902 تعداد دریافت فایل اصل مقاله: 1,990 |
||
