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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

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...

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Autores principales: Agarwal, Abhilasha, Ansari, Afroz Alam, Nath, Rajendra, Chak, Rakesh Kumar, Singh, Rajeev Kumar, Khanna, Richa, Singh, Prem Raj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Dental Society of Anesthsiology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10079769/
https://www.ncbi.nlm.nih.gov/pubmed/37034838
http://dx.doi.org/10.17245/jdapm.2023.23.2.69
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author Agarwal, Abhilasha
Ansari, Afroz Alam
Nath, Rajendra
Chak, Rakesh Kumar
Singh, Rajeev Kumar
Khanna, Richa
Singh, Prem Raj
author_facet Agarwal, Abhilasha
Ansari, Afroz Alam
Nath, Rajendra
Chak, Rakesh Kumar
Singh, Rajeev Kumar
Khanna, Richa
Singh, Prem Raj
author_sort Agarwal, Abhilasha
collection PubMed
description 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.
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spelling pubmed-100797692023-04-08 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 Agarwal, Abhilasha Ansari, Afroz Alam Nath, Rajendra Chak, Rakesh Kumar Singh, Rajeev Kumar Khanna, Richa Singh, Prem Raj J Dent Anesth Pain Med Original Article 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. The Korean Dental Society of Anesthsiology 2023-04 2023-03-28 /pmc/articles/PMC10079769/ /pubmed/37034838 http://dx.doi.org/10.17245/jdapm.2023.23.2.69 Text en Copyright © 2023 Journal of Dental Anesthesia and Pain Medicine https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Agarwal, Abhilasha
Ansari, Afroz Alam
Nath, Rajendra
Chak, Rakesh Kumar
Singh, Rajeev Kumar
Khanna, Richa
Singh, Prem Raj
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10079769/
https://www.ncbi.nlm.nih.gov/pubmed/37034838
http://dx.doi.org/10.17245/jdapm.2023.23.2.69
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