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It is important to choose an appropriate analgesia/sedation technique in pediatric dental treatment. Premedication combined with intravenous anesthesia is often used in deep sedation technique for pediatric dental treatment and it's a routine in most hospitals. Deep sedation has its unique advantages such as avoiding the airway damage with an enhanced recovery.
Dexmedetomidine is suitable for intranasal mucosal administration as a premedication drug. It has been proved with several beneficial characteristics in other clinical procedures.
This study intends to further explore the characteristics of nasal dexmedetomidine as premedication in pediatric oral treatment under deep sedation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| dexmedetomidine | Experimental | 2ug/kg intranasal atomized dexmedetomidine |
|
| midazolam | Active Comparator | 0.2mg/kg intranasal atomized midazolam |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dexmedetomidine | Drug | For dexmedetomidine group after ramdomization, an intranasal dose of 2ug/kg dexmedetomidine will be administrated. |
|
| Measure | Description | Time Frame |
|---|---|---|
| venipuncture acceptance | acceptance while starting the IV line, at most 2 tries | Day 0 |
| Measure | Description | Time Frame |
|---|---|---|
| Observer's Assessment of Alertness/Sedation(MOAA/S) Score | sedation scoring with MOAA/S scale(from intranasal drug administration till discharge) | Day 0 |
| remedial mask induction acceptance | acceptance of the mask induction(for those failed to start the IV before induction) |
| Measure | Description | Time Frame |
|---|---|---|
| peri-operative satisfaction | satisfaction of surgeon and parents during the whole clinical treatment and follow-up, they will be asked to give a score from 1 to 10, 10 stands for completely satisfied and 1 stands for not satisfied at all | up to 24 hours |
| post-operative condition of the child |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking University Hospital of Stomatology | Beijing | Beijing Municipality | 100081 | China |
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| ID | Term |
|---|---|
| D020927 | Dexmedetomidine |
| D008874 | Midazolam |
| ID | Term |
|---|---|
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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| Midazolam | Drug | For midazolam group after ramdomization, an intranasal dose of 0.2mg/kg midazolam will be administrated. |
|
| Day 0 |
| propofol dosage | the total dosage of propofol used from induction till the end of the clinical treatment | Day 0 |
| patients' discomfort | any adverse reaction or discomfort complaints of patients will be recorded, such as sneeze, blocked nose, bitter taste, dizziness, rhinalgia, etc. | up to 24 hours |
| hypoxemia | decreased oxygen saturation up to 90%, and the treatment will also be recorded(if any) | Day 0 |
| peri-operative blood pressure | peri-operative blood pressure states | Day 0 |
| peri-operative heart rate | peri-operative heart rate | Day 0 |
| times of intra-operative airway assistance | Any intra-operative airway assistance in need which aims to improve ventilation will be recorded, including jaw lifting, suction, mask ventilation and intubation. Specific type of assistance will also be recorded in detail. | Day 0 |
| post-operative pain | pain assessment with modified children's hospital of eastern Ontario pain score(m-CHEOPS) from the end of dental procedure till discharge | Day 0 |
| post-operative agitation | emergence agitation assessment with Pediatric Anesthesia Emergence Delirium scale(PAED) from the end of dental procedure till discharge | Day 0 |
| discharge time | time from the end of dental procedure till discharge | Day 0 |
complications and behavior changes assessed with Post-Hospitalization Behavior Questionnaire(PHBQ) |
| up to 24 hours |
| D001569 |
| Benzodiazepines |
| D001552 | Benzazepines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |