ABSTRACT
PURPOSE: The aim of this study was to establish a proper sedative protocol of dexmedetomidine for outpatients. MATERIALS AND METHODS: The study compared compare patients' pain, satisfaction, adverse events, and sedation depth during extraction of third molars using a sedative protocol of intravenous (IV; 1.0 µg/kg) versus intranasal (IN; 1.5 µg/kg) administration of dexmedetomidine. In total, 240 patients were randomized, 160 patients received dexmedetomidine, and data, including the amount of agent used, visual analog scale (VAS) pain score, adverse events, VAS score of patient satisfaction, and bispectral index, were recorded. RESULTS: Patients in the dexmedetomidine groups reported lower VAS pain scores and higher VAS satisfaction scores than patients in the local anesthesia group. There were no statistically meaningful differences between dexmedetomidine groups. Sedation with the IV route was slightly deeper than with the IN route. However, there were no statistically meaningful differences. CONCLUSION: IN or IV administration of dexmedetomidine is recommended as an effective, safe, and competent protocol in outpatient sedative surgeries.
Subject(s)
Conscious Sedation/methods , Dexmedetomidine/therapeutic use , Hypnotics and Sedatives/therapeutic use , Molar, Third/surgery , Tooth Extraction/methods , Administration, Intranasal , Adolescent , Adult , Clinical Protocols , Dexmedetomidine/administration & dosage , Female , Humans , Hypnotics and Sedatives/administration & dosage , Infusions, Intravenous , Male , Middle Aged , Young AdultABSTRACT
In pediatric dentistry, chloral hydrate is habitually selected for sedation of uncooperative children. Although chloral hydrate has been used for decades, various adverse effects are reported and necessity for new alternative drugs has increased. Dexmedetomidine was approved by FDA for sedation at intensive care units (ICU) in 1999. Compared to conventional sedative drugs, dexmedetomidine has not only analgesic and sedative effects but also it barely suppresses the respiratory system. Due to these characteristics, dexmedetomidine is known as safe sedative drug for children and elderly patients. Furthermore, approved by KFDA in 2010 in Korea, the frequency of sedation using dexmedetomidine is increasing. However, due to its intravenous administration method, it was difficult to apply in pediatric dentistry. Recently, intranasal administration method was introduced which might be a new possible alternative of oral sedation. In this study, we compare the mechanisms, pros and cons of chloral hydrate and dexmedetomidine, introducing new possibilities.
