Comparative evaluation of intranasal midazolam-ketamine, dexmedetomidine-ketamine, midazolam-fentanyl, and dexmedetomidine-fentanyl combinations for procedural sedation and analgesia in pediatric dental patients: a randomized controlled trial.

Abhilasha Agarwal, Afroz Alam Ansari, Rajendra Nath, Rakesh Kumar Chak, Rajeev Kumar Singh, Richa Khanna, Prem Raj Singh
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引用次数: 1

Abstract

Background: In order to assess the effectiveness of various analgesio-sedative combinations for pain relief and sedation in pediatric dental patients, a thorough evaluation of clinical studies and patient outcomes is necessary.

Methods: A total of 128 healthy, uncooperative pediatric dental patients were randomly allocated to receive one of the four combinations of drugs via the intranasal (IN) route: Group I received midazolam-ketamine (MK), Group II received dexmedetomidine-ketamine (DK), Group III received midazolam-fentanyl (MF), and Group IV received dexmedetomidine-fentanyl (DF) in a parallel-arm study design. The efficacy and safety of the combinations were evaluated using different parameters.

Results: The onset of sedation was significantly faster in the DF group than in the DK, MF, and MK groups (P < 0.001). The depth of sedation was significantly higher in the DK and DF groups than in the MK and MF groups (P < 0.01). DK and DF produced significant intra- and postoperative analgesia when compared with combinations of MK and MF. No significant adverse events were observed for any of the combinations.

Conclusions: The DK and DF groups showed potential as analgesio-sedatives in view of their anxiolytic and analgesic effects.

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鼻内咪达唑仑-氯胺酮、右美托咪啶-氯胺酮、咪达唑仑-芬太尼和右美托咪啶-芬太尼联合用于小儿牙科患者手术镇静和镇痛的比较评价:一项随机对照试验。
背景:为了评估各种镇痛-镇静组合对儿童牙科患者镇痛和镇静的有效性,有必要对临床研究和患者结果进行全面的评估。方法:128例健康、不配合的儿童牙科患者随机分为四组,经鼻内(IN)给药:I组给咪达唑仑-氯胺酮(MK), II组给右美托咪啶-氯胺酮(DK), III组给咪达唑仑-芬太尼(MF), IV组给右美托咪啶-芬太尼(DF)。采用不同的参数评价联合用药的有效性和安全性。结果:DF组镇静起效明显快于DK、MF、MK组(P < 0.001)。DK、DF组大鼠的镇静深度显著高于MK、MF组(P < 0.01)。与MK和MF联合使用相比,DK和DF在术中和术后镇痛效果显著。未观察到任何联合用药的显著不良事件。结论:DK组和DF组具有抗焦虑和镇痛作用,具有潜在的镇痛镇静作用。
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