Atomized Intranasal Sedation Efficacy in Children Undergoing Dental Treatment: A Comparative Randomized Clinical Study

Introduction: Dental fear and anxiety, especially in children, are the most common reason for avoiding dental treatment. Paediatric dental sedation as a means of pharmacologic behaviour management is gaining momentum to manage young difficult children. Hence, the purpose of this study was to assess the efficacy of intranasal (IN) midazolam (MID) and newly introduced dexmedetomidine (DEX) as conscious sedation agents in uncooperative children planned for dental extractions. Materials and Methods: Fifty uncooperative children, 4–8 years of age with no systemic disease were digitally randomized into two groups. Each patient was administered with either 0.3 mg/kg MID or 1.5 µg/kg DEX intranasally. The children’s behaviour and haemodynamic parameters were recorded during parental separation, local anaesthesia administration and while undergoing dental extractions. Chi-square, unpaired t -test and ANOVA were run to statistically analyse the data at a significance level of P < 0.05. Results: More number of children showed successful parental separation (80%) in the DEX group as compared to MID and it was statistically significant ( P = 0.029). A statistically significant decrease in heart rate and systolic and diastolic blood pressure was noticed from baseline till extraction with DEX. The treatment was completed successfully in both the groups with no significant difference ( P = 0.34). Conclusion: DEX provided better control of preoperative anxiety in terms of parental separation. Haemodynamic parameters decreased significantly with DEX but no clinical intervention was required. To manage anxious and uncooperative behaviour of children, IN DEX can be a vital in-office sedation agent.