Mulay Mrudula, Mahajan Amit, Shah Navin, Shah Rakesh, Chandalia Saurabh, Soni Dharang
Vadodara, Gujarat 391760 India Oral and Maxillofacial Surgery, K.M Shah Dental College and Hospital.
J Maxillofac Oral Surg. 2023 Jun 4;22(3):1-7. doi: 10.1007/s12663-023-01933-4.
Dexmedetomidine has dose-dependent selectivity for alpha 2 adrenoceptors. It is a good sedative with analgesic characteristics and good haemodynamic stability. Intranasal sedation is a non-invasive medication delivery method that is both safe and well accepted by both children and adults. One of the most common procedures in maxillofacial surgery is transalveolar extraction. In minor oral surgery, a painless transalveolar extraction with little post-operative pain would be ideal.
To examine the effectiveness of intranasal dexmedetomidine spray against intranasal normal saline spray in patients undergoing transalveolar extractions for anxiety relief.
We compared sedation effect by Ramsay sedation scale, analgesia by visual analogue scale, monitored BP and pulse rate for anxiety, and spo2 levels for any complication in this prospective double-blinded randomized control study for two groups, A group with intranasal dexmedetomidine spray and the B group of intranasal NS spray for placebo effect at 0 min, 15 min, 30 min, and 45 min until transalveolar extraction.
As a result of the intranasal spray of dexmedetomidine, there were no related problems such as respiratory depression. There was a substantial difference in sedation and analgesia between group A and the placebo group, as well as a significant decrease in pulse rate and hypotension in the dexmedetomidine group to reduce anxiety.
Intranasal injection of atomized dexmedetomidine (1.5 mcg/kg) for patient sedation having transalveolar extractions or other minor surgical operations in oral and maxillofacial surgery is clinically effective, convenient, lowers anxiety, and safe.: No. CTRI/2021/07/035181.
右美托咪定对α2肾上腺素能受体具有剂量依赖性选择性。它是一种具有镇痛特性且血流动力学稳定性良好的优质镇静剂。鼻内镇静是一种非侵入性给药方法，儿童和成人都能安全接受且广泛认可。上颌窦穿刺拔牙是颌面外科最常见的手术之一。在小型口腔手术中，理想的情况是进行无痛上颌窦穿刺拔牙且术后疼痛轻微。
探讨经鼻应用右美托咪定喷雾剂与经鼻应用生理盐水喷雾剂相比，对接受上颌窦穿刺拔牙患者缓解焦虑的有效性。
在这项前瞻性双盲随机对照研究中，我们通过Ramsay镇静评分比较镇静效果，通过视觉模拟评分比较镇痛效果，监测血压和脉搏率以评估焦虑程度，并监测血氧饱和度水平以检测任何并发症。A组经鼻应用右美托咪定喷雾剂，B组经鼻应用生理盐水喷雾剂作为安慰剂对照，在0分钟、15分钟、30分钟和45分钟时进行测量，直至完成上颌窦穿刺拔牙。
经鼻喷洒右美托咪定后，未出现呼吸抑制等相关问题。A组与安慰剂组在镇静和镇痛方面存在显著差异，右美托咪定组的脉搏率显著降低且出现低血压，从而减轻了焦虑。
经鼻注射雾化右美托咪定（1.5微克/千克）用于口腔颌面外科接受上颌窦穿刺拔牙或其他小型外科手术患者的镇静，在临床上是有效的、方便的，可降低焦虑且安全。试验注册号：CTRI/2021/07/035181
