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右美托咪定与氯胺酮联合口腔给药在儿童牙科镇静中的有效性:一项随机对照临床试验。

Effectiveness of buccal administration of dexmedetomidine and ketamine combination in paediatric dental sedation: A randomized controlled clinical trial.

作者信息

El-Rouby Sara H, Crystal Yasmi O, Elshafie Ahmed M, Wahba Nadia A, El-Tekeya Magda M

机构信息

Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.

Department of Pediatric Dentistry, NYU College of Dentistry, New York, New York, USA.

出版信息

Int J Paediatr Dent. 2025 Mar;35(2):359-368. doi: 10.1111/ipd.13238. Epub 2024 Jul 16.

Abstract

BACKGROUND

Pain and anxiety can be considerable obstacles while treating paediatric dental patients. Moderate sedation is needed to treat uncooperative patients.

AIM

This study aimed to compare the effectiveness of buccal administration of dexmedetomidine-ketamine combination versus dexmedetomidine.

DESIGN

Fifty-six uncooperative children were randomly assigned into two groups: Group I received buccal dexmedetomidine (2 μg/kg) and ketamine (2 mg/kg) (DEX-KET), whereas Group II received buccal dexmedetomidine (4 μg/kg) (DEX). The effects of drugs were evaluated based on changes in vital signs, onset and duration of sedation, sedation level, analgesia, ease of treatment and procedural adverse effects.

RESULTS

There were no significant differences in vital signs or sedation onset between the two groups. DEX-KET group showed shorter recovery time than DEX group (p < .0001). There were no statistically significant differences between both groups regarding sedation level at optimum sedation and during operative procedure (p = .064, p = .069 respectively). The ease of treatment was significantly better in DEX-KET group than in DEX group (p = .048). Procedural side effects and analgesic effects of the sedative drugs were comparable between both groups.

CONCLUSION

The combination of dexmedetomidine and ketamine delivered buccally provided a better method of delivering care to uncooperative children with more rapid recovery than dexmedetomidine.

摘要

背景

在治疗儿童牙科患者时,疼痛和焦虑可能是相当大的障碍。治疗不合作的患者需要适度镇静。

目的

本研究旨在比较经颊给予右美托咪定-氯胺酮组合与右美托咪定的有效性。

设计

56名不合作的儿童被随机分为两组:第一组经颊给予右美托咪定(2μg/kg)和氯胺酮(2mg/kg)(DEX-KET),而第二组经颊给予右美托咪定(4μg/kg)(DEX)。根据生命体征的变化、镇静的起效时间和持续时间、镇静水平、镇痛效果、治疗的难易程度以及操作过程中的不良反应来评估药物的效果。

结果

两组之间的生命体征或镇静起效时间没有显著差异。DEX-KET组的恢复时间比DEX组短(p <.0001)。在最佳镇静状态和手术过程中,两组之间的镇静水平没有统计学上的显著差异(分别为p =.064,p =.069)。DEX-KET组的治疗难易程度明显优于DEX组(p =.048)。两组之间镇静药物的操作过程中的副作用和镇痛效果相当。

结论

经颊给予右美托咪定和氯胺酮的组合为治疗不合作儿童提供了一种更好的护理方法,其恢复速度比右美托咪定更快。

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