Department of Paediatric and Preventive Dentistry, I.T.S Dental College, Hospital and Research Centre, Greater Noida, Uttar Pradesh, India.
J Indian Soc Pedod Prev Dent. 2021 Jul-Sep;39(3):233-239. doi: 10.4103/jisppd.jisppd_517_20.
Pain, fear, and anxiety have long been associated with pediatric dentistry. A child's cooperation with a dental.procedure.usually requires various behavioral management strategies conveyed by the entire dental team. The use of sedatives in dental clinics for providing analgesia and anxiolysis allows the patient to respond appropriately to verbal commands and light tactile stimulation., thus making dental treatment more patient friendly and effective.
The aim of this study was to compare the safety and efficacy of dexmedetomidine versus midazolam for the management of pediatric patients in the dental clinic.
This systematic review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six articles were selected for this systematic review. Of them, only in four articles, homogeneous data were available which were subjected to meta-analysis.
When compared with midazolam, premedication with dexmedetomidine resulted in much lower incidence of emergence delirium (odds ratio = 0.07, 95% confidence interval: 0.01-0.54, P = 0.01). No significant difference was observed with respect to satisfactory behavior of the child, successful parental separation, and satisfactory mask acceptance following sedation.
Both dexmedetomidine and midazolam are equally effective for the management of pediatric patients in the dental clinic. In addition, dexmedetomidine premedication is associated with lower incidence of emergence delirium and has a better margin of safety.
疼痛、恐惧和焦虑长期以来一直与儿童牙科相关。儿童与牙科治疗配合通常需要整个牙科团队传达各种行为管理策略。在牙科诊所使用镇静剂来提供镇痛和抗焦虑作用，可以使患者对口头命令和轻度触觉刺激做出适当反应，从而使牙科治疗更加患者友好和有效。
本研究旨在比较右美托咪定与咪达唑仑用于管理牙科诊所中儿科患者的安全性和疗效。
本系统评价根据系统评价和荟萃分析的首选报告项目准备。选择了六篇文章进行本系统评价。其中，只有在四篇文章中，有同质数据，这些数据被进行了荟萃分析。
与咪达唑仑相比，使用右美托咪定进行预给药可使出现谵妄的发生率显著降低（优势比=0.07，95%置信区间：0.01-0.54，P=0.01）。在镇静后儿童的行为表现令人满意、成功分离父母以及面罩接受度方面，两种药物之间没有显著差异。
右美托咪定和咪达唑仑在管理牙科诊所中的儿科患者方面同样有效。此外，右美托咪定预给药与较低的谵妄发生率相关，并且具有更好的安全性。
