Background. Psychological methods are the preferred behavior management techniques (BMTs) for children in the dental clinical set. However, sometimes they are not successful. On such occasions, pharmacological methods can be good alternatives. Intravenous sedation is one of these methods, which are very useful in behavior management. It is highly effective when applied appropriately.Objectives. The aim of this study was to evaluate the efficacy of intravenous sedation using dexmedetomidine in comparison with ketamine and atropine in uncooperative children during dental treatment.Material and methods. The study was performed on 40 healthy uncooperative children aged 2-6 years. They were equally and randomly divided into 2 groups: group D -intravenous dexmedetomidine with a loading dose of 1 µg/kg body weight (b.w.), which was followed by 0.2 µg/kg b.w./h via continuous infusion; and group K -intravenous ketamine 2 mg/kg b.w. with atropine 0.01 mg/kg b.w. Vital signs, recovery time and adverse effects were all recorded. Behavior was also evaluated using the Ohio State University Behavioral Rating Scale (OSUBRS).Results. Statistically significant differences appeared in the degree of behavior between the 2 groups (p = 0.03). Group D did better than group K. The mean recovery time was shorter in group D than in group K, but there were no statistically significant differences (p = 0.12). No side effects, episodes of cardiovascular or respiratory instability were reported in either group.Conclusions. The use of intravenous sedation in managing uncooperative children is more effective with dexmedetomidine than with ketamine. The addition of atropine as an adjunct to intravenous ketamine sedation helps in preventing complications. Cite asHammadyeh AR, Altinawi MK, Rostom F. Comparison of two intravenous sedation techniques for use in pediatric dentistry: A randomized controlled trial. Dent Med Probl.
Objective. This study aimed to compare the intranasal administration of midazolam and dexmedetomidine in uncooperative children with Down syndrome. Materials and Methods. The sample consisted of 20 children with Down syndrome aged 5 to 11 years who were divided equally into two groups: Group 1 (experimental) nasal dexmedetomidine and Group 2 (control) nasal midazolam. The efficacy of both the drugs was evaluated according to Ohio State University Behavioral Rating Scale (OSUBRS), University of Michigan scale (UMSS), and Houpt general behavior scale. Results. Both substances have been effective in the management of children with Down syndrome. There were no statistically significant differences for Ohio State University Behavioral Rating Scale (OSUBRS) ( P value = 0.631), University of Michigan scale (UMSS) ( P value = 0.739), and Houpt general behavior scale ( P value = 0.481). Conclusion. Both midazolam and dexmedetomidine nasal can be used to sedate children with Down syndrome.
Objectives: Dental procedures are always associated with some degree of anxiety, and children are usually more prone to it. General anesthesia may have to be used in more complex procedures, but many dental procedures can successfully be undertaken with therapeutic sedation. The aim of this trial was to evaluate the effectiveness of oral sedation using dexmedetomidine in comparison with ketamine in the management of uncooperative pediatric patients during dental treatment. Methodology: A randomized clinical trial was carried out on 40 ASA physical status-I children aged 2-6 y to investigate the effect of using dexmedetomidine and ketamine with atropine for sedation. The children were equally and randomly divided into two groups: Group K: received oral ketamine 5 mg/kg with atropine 0.01 mg/kg, and Group D: received oral dexmedetomidine 3 µg/kg. Recovery time, vital signs, and side effects were all recorded. Behavior rating was also assessed using the Ohio State University Behavioral Rating Scale (OSUBRS). Results: The children in Group D were more sedated than in Group K, but the difference was not statistically significant (p = 0.22). The median recovery time was significantly shorter in Group D than in Group K (p = 0.003). No adverse effects, episodes of respiratory or cardiovascular instability were noted in either groups. Conclusions: Oral dexmedetomidine is equally effective to oral ketamine for sedation in children undergoing outpatient dental procedures, but has relatively a shorter recovery time. Citation: Hammadyeh A, Altinawi M, Rostom F. Two oral sedation regimens in pediatric dentistry: a randomized controlled trial. Anaesth pain & intensive care 2019;23(4)__
The purpose of this study was to compare the efficacy and recovery time of inhalation sedation using sevoflurane to intravenous sedation using propofol. Materials and Methods:The study included 46 uncooperative children aged (3-6) year's who needed to undergo dental treatments under deep sedation. They were randomly assigned to two groups, the propofol group (Group P) and the sevoflurane group (Group S). All children were sedated by an anesthesiologist who was independent of dental treatment and was wholly responsible for the sedation procedure until the patient was discharged. The efficacy assessments and depth of sedation evaluation were done using the University of Michigan Sedation Scale (UMSS). After treatment, modified Vancouver Recovery Scale (MVRS) scale was used to determine the recovery time until the patient was discharged. Results: There were no significant differences in efficacy between groups. Statistically significant differences appeared in the recovery time between groups (p = .000). Conclusions: inhalation deep sedation with sevoflurane is an effective as propofol sedation in managing uncooperative children and the recovery of sevoflurane sedation was more quickly than propofol sedation.
Introduction: Recently, there has been an increasing need for sedation techniques to reduce anxiety in children undergoing painful diagnostic and therapeutic procedures. Therefore, multiple tactics (oral sedation, Intravenous (IV) sedation) were devised to help practitioners manage such cases. Aim: To determine the efficiency and effects of propofol on the behaviour of anxious children during dental treatment. Materials and Methods: This interventional study was conducted at Damascus University, Damascus, Syria, from August 2018 to September 2020. Total 23 children aged 3 to 6 years who were physically healthy (American Society of Anesthesiologists I (ASA I) and uncooperative (negative or definitely negative according to Frankel’s behaviour scale) were included to determine the effects of intravenous propofol on their behaviour during treatment. Behaviour during treatment was evaluated using the Ohio State University Behavioural Rating Scale (OSUBRS). Also, the sedation level was evaluated using the University of Michigan Sedation Scale (UMSS). Mann-Whitney test was used to compare the levels of behaviour and degrees of sedation between males and females. The significance level was set at p-value <0.05. Results: Behaviour according to OSUBRS and degree of sedation according to UMSS during treatment were favourable, and treatment was completed for all participants. The Mann-Whitney test showed no statistically significant difference between males and females regarding the level of behaviour (p-value=0.605) or the degree of sedation (p-value=0.376). A strong positive relationship between treatment time and awakening time was found using the Pearson’s correlation coefficient (0.813, p-value<0.01). Conclusion: In the presence of an anaesthesiologist, intravenous propofol deep sedation was considered effective in managing anxious and uncooperative children during dental treatment.
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