Mahdavi Alireza, Fallahinejad Ghajari Masoud, Ansari Ghassem, Shafiei Leila
Assistant Professor, Department of Anesthesia, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Professor, Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Dent (Tehran). 2018 Mar;15(2):79-85.
The aim of this study was to compare the intranasal premedication effect of newly introduced dexmedetomidine (DEX) versus midazolam on the behavior of uncooperative children in the dental clinic.
This crossover double-blind clinical trial was conducted on 20 uncooperative children aged 2-6 years who required at least two similar dental treatment visits. The subjects were randomly given 1 μg/kg of DEX and 0.5 mg/kg of midazolam via the intranasal route. For the sedation protocol in the two groups, 0.25 mg/kg of atropine in combination with 0.5 mg/kg of midazolam added to 1-2 mg/kg of ketamine were used 30 minutes after premedication and transferring the patient to the operating room. Dental treatments were carried out by a pediatric dentist blinded to the type of the administered premedication. The sedative efficacy (overall success rate) of the agents was assessed by two independent pediatric dentists based on the Houpt scale. Data analyses were carried out according to Wilcoxon signed-rank test and paired t-test.
There were no significant differences in the premedication efficacy of intranasal DEX and midazolam according to the Houpt scale (P>0.05).
Intranasal midazolam and DEX are satisfactory and effective premedication regimens for uncooperative children.
本研究旨在比较新引入的右美托咪定（DEX）与咪达唑仑对牙科诊所中不合作儿童行为的鼻内术前用药效果。
本交叉双盲临床试验针对20名年龄在2至6岁之间、需要至少两次类似牙科治疗就诊的不合作儿童进行。受试者通过鼻内途径随机给予1μg/kg的DEX和0.5mg/kg的咪达唑仑。对于两组的镇静方案，在术前用药并将患者转移至手术室30分钟后，使用0.25mg/kg的阿托品与0.5mg/kg的咪达唑仑联合加入1至2mg/kg的氯胺酮。牙科治疗由对所给予的术前用药类型不知情的儿科牙医进行。药物的镇静效果（总体成功率）由两名独立的儿科牙医根据豪普特量表进行评估。数据分析根据威尔科克森符号秩检验和配对t检验进行。
根据豪普特量表，鼻内DEX和咪达唑仑的术前用药效果无显著差异（P>0.05）。
鼻内咪达唑仑和DEX是用于不合作儿童令人满意且有效的术前用药方案。
