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Since the 1970s, ketamine has been used in clinical anesthesia treatment. Compared with ketamine, esketamine has a higher clearance rate, so it has a shorter recovery time after anesthesia. This feature also makes ketamine more suitable for pediatric dental patients.The purpose of this study was to investigate and compare the efficacy of esketamine sedation and fentanyl sedation in pediatric dental patients
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Fentanyl group | Active Comparator | The fentanyl group was prepared by 1ug/kg fentanyl in 5ml normal saline, assembled with 5ml injection, labeled as "Anesthesia inducer". Midazolam 0.05mg/kg+ "Anesthesia inducer" was applied to all patients for procedural induction by intravenous injection. According to the MOAA/S score of the patients, midazolam could be added 0.5mg per time at more than 2 minutes until the MOAA/S score reached 3, the maximum infusion dose of midazolam was less than 10mg and less than 0.1mg/kg. |
|
| Esketamine group | Experimental | The esketamine group was prepared by 0.5mg/kg esketamine in 5ml normal saline, assembled with 5ml injection, labeled as "Anesthesia inducer". Midazolam 0.05mg/kg+ "Anesthesia inducer" was applied to all patients for procedural induction by intravenous injection. According to the MOAA/S score of the patients, midazolam could be added 0.5mg per time at more than 2 minutes until the MOAA/S score reached 3, the maximum infusion dose of midazolam was less than 10mg and less than 0.1mg/kg. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fentanyl | Drug | The fentanyl group was prepared by 1ug/kg fentanyl in 5ml normal saline, assembled with 5ml injection, labeled as "Anesthesia inducer". |
|
| Measure | Description | Time Frame |
|---|---|---|
| Hypoxemia | The incidence of intraoperative hypoxemia (Spo2<92%) | Day 0 |
| Midazolam use | The total use of midazolam | Day 0 |
| Measure | Description | Time Frame |
|---|---|---|
| Successful sedation | Success rate of sedation | Day 0 |
| Respiratory depression | Incidence of intraoperative respiratory depression and the need for airway support such as mandibular dragging |
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Inclusion Criteria:
Age 6-14 years old.
Oral out-patient sedative treatment in our hospital.
Exclusion Criteria:
Patients who are allergic to esketamine, opioids, propofol, or have contraindications for these drug use.
Patients with mental illness or who are unable to cooperate.
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| Name | Affiliation | Role |
|---|---|---|
| Xudong Yang, MD | Department of anesthesiology of peking university school of stomatology | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking University Hospital of Stomatology | Beijing | Beijing Municipality | 100081 | China |
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| ID | Term |
|---|---|
| D005283 | Fentanyl |
| C000629870 | Esketamine |
| D008874 | Midazolam |
| ID | Term |
|---|---|
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D001569 | Benzodiazepines |
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Fentanyl group and Esketamine group
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| Esketamine | Drug | The esketamine group was prepared by 0.5mg/kg esketamine in 5ml normal saline, assembled with 5ml injection, labeled as "Anesthesia inducer". |
|
| Midazolam | Drug | Midazolam 0.05mg/kg+ "Anesthesia inducer" was applied to all patients for procedural induction by intravenous injection. According to the MOAA/S score of the patients, midazolam could be added 0.5mg per time at more than 2 minutes until the MOAA/S score reached 3, the maximum infusion dose of midazolam was less than 10mg and less than 0.1mg/kg. |
|
| Day 0 |
| Agitation and delirium | The incidence of agitation and delirium during and after operation | Day 0 |
| Circulatory fluctuation | Occurrence of hypertension, hypotension, bradycardia, tachycardia and other side effects | Day 0 |
| Propofol requiring | Incidence of sedation requiring propofol | Day 0 |
| Time of successful sedation | The time when the MOAA/S score was equal to 3 points for the first time after patients were given anesthetic inducer | Day 0 |
| MOAA/S score in recovery room | MOAA/S score of patients every 15 minutes after entering the recovery room | Day 0 |
| The time for Modified Observer Assessment of Sedation Score(MOAA/S)>4 | The time for MOAA/S score to be greater than 4 since the end of clinical operation and the cessation of anesthetic infusion. MOAA/S is from 0 to 5, the higher of the score means the less sedative condition. | Day 0 |
| Directional force recovery time | Recovery time of directional force | Day 0 |
| Recall of intraoperative events | The child's recall of intraoperative events | Day 0 |
| Treatment comfort score | Patients' satisfaction score of treatment comfort. This score is from 0 to 10, the higher of the score means the more comfortable of the treatment patients received. | Day 0 |
| The incidence of complications | The incidence of patients suffered from pain, drowsiness, vomiting, nausea, mental emotion,within 1 day after treatment | Day 1 |
| Visual Analogue Scale(VAS) of pain in recovery room | Evaluate patients' VAS of pain every 15 minutes after entering the recovery room. This scale is from 0 to 10, the higher of the scale means the more painful patients feel. | Day 0 |
| D001552 |
| Benzazepines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |