Comparison of two intravenous sedation techniques for use in pediatric dentistry: A randomized controlled trial

Abstract

Background. Psychological methods are the preferred behavior management techniques (BMTs) for children in the dental clinical set. However, sometimes they are not successful. On such occasions, pharmacological methods can be good alternatives. Intravenous sedation is one of these methods, which are very useful in behavior management. It is highly effective when applied appropriately. Objectives. The aim of this study was to evaluate the efficacy of intravenous sedation using dexmedetomidine in comparison with ketamine and atropine in uncooperative children during dental treatment. Material and methods. The study was performed on 40 healthy uncooperative children aged 2–6 years. They were equally and randomly divided into 2 groups: group D – intravenous dexmedetomidine with a loading dose of 1 µg/kg body weight (b.w.), which was followed by 0.2 µg/kg b.w./h via continuous infusion; and group K – intravenous ketamine 2 mg/kg b.w. with atropine 0.01 mg/kg b.w. Vital signs, recovery time and adverse effects were all recorded. Behavior was also evaluated using the Ohio State University Behavioral Rating Scale (OSUBRS). Results. Statistically significant differences appeared in the degree of behavior between the 2 groups (p = 0.03). Group D did better than group K. The mean recovery time was shorter in group D than in group K, but there were no statistically significant differences (p = 0.12). No side effects, episodes of cardiovascular or respiratory instability were reported in either group. Conclusions. The use of intravenous sedation in managing uncooperative children is more effective with dexmedetomidine than with ketamine. The addition of atropine as an adjunct to intravenous ketamine sedation helps in preventing complications.