Intranasal Sedation Combos Containing Dexmedetomidine Outperform Those Containing Midazolam

Background: Midazolam, ketamine, dexmedetomidine, and fentanyl have been used alone and in combination for procedural sedation in children. This study looked at 4 combinations of these drugs, all administered intranasally. Objective: To determine differences between intranasal sedation regimens in pediatric dental patients. Design: Randomized controlled trial. Participants: 128 healthy children aged 4 to 9 years scheduled to receive restorative treatment involving pulp therapy. Methods: Patients were randomly allocated to 1 of 4 intranasal sedation groups: midazolam-ketamine (MK), dexmedetomidine-ketamine (DK), midazolam-fentanyl (MF), and dexmedetomidine-fentanyl (DF). Drugs were administered intranasally via mucosal atomization device, and operative procedures were completed. A calibrated observer assessed sedation depth, behavior, analgesia, treatment completion, satisfaction, recovery time, and adverse effects. Results: No statistically significant differences were found in demog more...