Comparative study between novel sedative drug (dexmedetomidine) versus midazolam–propofol for conscious sedation in pediatric patients undergoing oro-dental procedures

Taher, Waleed M.A. Al; Mansour, Emad; Shafei, Mohamed N. El

doi:10.1016/j.egja.2010.04.002

Cited by 17 publications

(15 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This pilot investigation reported the successful safe and efficient use of dexmedetomidine in pediatric dental patients as intravenous deep sedative agent. The results of this investigation corroborate with few recent reports on dexmedetomidine where safe successful usage of this drug in pediatric dental settings have been reported [16][17][18]. However, a direct comparison should be drawn with caution because of a variety of routes [16,17] and dosages [18] employed in these reports.…”

Section: Discussionsupporting

confidence: 81%

“…The results of this investigation corroborate with few recent reports on dexmedetomidine where safe successful usage of this drug in pediatric dental settings have been reported [16][17][18]. However, a direct comparison should be drawn with caution because of a variety of routes [16,17] and dosages [18] employed in these reports. Also, previous authors [16][17][18] employed this agent for moderate sedation while we targeted deep sedation.…”

Section: Discussionsupporting

confidence: 81%

“…However, a direct comparison should be drawn with caution because of a variety of routes [16,17] and dosages [18] employed in these reports. Also, previous authors [16][17][18] employed this agent for moderate sedation while we targeted deep sedation. We targeted deep sedation instead of moderate sedation as subjects were young, i.e., 2-6 years old and for this age group levels of sedation consistent with deep sedation are considered to be more reliable [1,26].…”

Section: Discussionmentioning

confidence: 99%

“…Dexmedetomidine has also earned its status as a potential sedative for dental procedures in adult as well as pediatric age group [15]. Few recent reports have described its safe and efficient use for moderate sedation in pediatric dental patients through a variety of routes [16][17][18]. But, no data has been published on its intravenous use as a deep sedative agent for invasive dental procedures in this age group.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Dexmedetomidine: A Preliminary Exploration of its Safety and Efficacy in Pediatric Dental Setting

Mittal¹,

Srivastava²,

Haider³

2015

J Anesth Clin Res

View full text Add to dashboard Cite

Objective: To report on safety and efficacy of intravenous usage of Dexmedetomidine for endodontic intervention in young and anxious pediatric patients. Methods:This prospective pilot investigation enrolled 10 healthy ASA status I, 2-6 year old children who were anxious (Venham's score ≥ 4) and were scheduled to undergo primary molar pulpectomy under sedation. Sedation induction was done with 1 mg/kg of propofol bolus followed by 0.2-0.8 µg/kg of dexmedetomidine infusion for maintenance. Sedation was titrated to achieve Houpt's overall behavior score of ≥ 4. In case of insufficient sedation, rescue propofol boluses (1 mg/kg) were administered. Vitals were monitored every 5 minutes and recovery was evaluated using Alderete Modified Post Anesthesia Discharge Scoring System. Adverse events, i.e., ≥ ± 20% baseline fluctuations in vital signs, tachycardia, bradycardia, apnea, desaturation, stridor and/or laryngospasm were recorded. Results:The procedure was successfully completed in all of the subjects with the current sedation regime as per the study protocol. Rescue propofol boluses were needed in 8 subjects. No untoward fluctuations in vital signs or adverse events were reported in either intra-operative phase or post-operatively. Conclusion:Intravenous Dexmedetomidine is safe and efficient sedative for endodontic intervention in young and anxious pediatric patients.

show abstract

Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Dexmedetomidine: A Preliminary Exploration of its Safety and Efficacy in Pediatric Dental Setting

Mittal¹,

Srivastava²,

Haider³

2015

J Anesth Clin Res

View full text Add to dashboard Cite

show abstract

“…The DK group showed significantly less sedation failure and the need for rescue medication was significantly lower. Al Taher et al . also compared dexmedetomidine with midazolam plus propofol and showed a significantly faster recovery time postprocedure (measured as the time from stoppage of drug infusion until reaching a Ramsey score 2), and a significantly higher MAP in the dexmedetomidine group.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Dexmedetomidine as a Sole Sedative Agent in Small Diagnostic and Therapeutic Procedures: A Systematic Review

et al. 2016

View full text Add to dashboard Cite

Dexmedetomidine is an upcoming agent with sedative, anxiolytic, and analgesic properties. This review summarizes empirical evidence for the efficacy of dexmedetomidine as a sole sedative agent, and its effectiveness for small diagnostic and therapeutic procedure, in comparison with other frequently used sedatives. All randomized controlled trials on the effect of dexmedetomidine were reviewed. Pain level, patient satisfaction, operator satisfaction, procedure duration, recovery time, and hemodynamic and respiratory characteristics were examined. A total of 1993 patients (1,621 adults; 372 children) from 35 studies were included. In the adult studies, dexmedetomidine yielded significantly lower pain levels compared to the other sedatives (in 31.25% of the included studies) and significantly more patient satisfaction (68.2%). In studies on children, more favorable results concerning respiratory safety and the level of adequate sedation were found compared to the control sedatives. Implications for future studies are discussed.

show abstract

Incidence of bradycardia in pediatric patients receiving dexmedetomidine anesthesia: a meta-analysis

Gong

Man

2016

Int J Clin Pharm

View full text Add to dashboard Cite

Background Dexmedetomidine, an α2-receptor agonist, provides potent sedation, analgesia, and anxiolysis without respiratory depression and is used in a variety of surgical and procedural situations. Aim of the review The aim of this study was to estimate the incidence of bradycardia in pediatric patients who received dexmedetomidine as a sole agent for any procedural, intensive care or surgical sedation. Method Literature was searched in electronic databases and studies were selected by following pre-determined eligibility criteria. Meta-analyses were carried out by pooling the percent incidence of bradycardia to attain a weighted overall effect size. Age-wise subgroup analyses and meta-regression analyses for the identification of factors affecting the incidence were also performed. Results Data of 2835 patients from 21 studies were included. The mean age was 62.21 ± 35.68 months. Initial, maintenance and total doses of dexmedetomidine (mean ± standard deviation) were 1.63 ± 0.33 μg/kg body weight, 0.86 ± 0.68 μg/kg/h, and 26.7 ± 20.8 μg/kg. The overall incidence of bradycardia (95% confidence interval) was 3.067 (2.863, 3.270)%; P < 0.0001. However, range was wider (0-22%) with 9 studies observed 0% incidence. The mean change in the heart rate was -17.26 (-21.60, -12.92); P < 0.00001. In the meta-regression analyses, age, body weight and dexmedetomidine dose were not significantly associated with the incidence of bradycardia. The minimum heart rate observed during the dexmedetomidine treatment period was positively associated with baseline heart rate. Conclusion Incidence of bradycardia in dexmedetomidine treated pediatric patients is 3%.

show abstract

Comparative study between novel sedative drug (dexmedetomidine) versus midazolam–propofol for conscious sedation in pediatric patients undergoing oro-dental procedures

Cited by 17 publications

References 22 publications

Dexmedetomidine: A Preliminary Exploration of its Safety and Efficacy in Pediatric Dental Setting

Dexmedetomidine: A Preliminary Exploration of its Safety and Efficacy in Pediatric Dental Setting

Efficacy of Dexmedetomidine as a Sole Sedative Agent in Small Diagnostic and Therapeutic Procedures: A Systematic Review

Incidence of bradycardia in pediatric patients receiving dexmedetomidine anesthesia: a meta-analysis

Contact Info

Product

Resources

About