A comparative evaluation of intranasal dexmedetomidine with and without nalbuphineas premedication for pediatric dental patients

Abstract

Management of children’s fear and anxiety during treatment is a primary concern of paediatric dental practitioners. There are a number of children who are difficult to be managed by basic behaviour guidance techniques.To evaluate the safety and efficacy of intranasal Dexmedetomidine with and without Nalbuphine procedural sedation in paediatric dental patients.: This study was conducted in Department of Pedodontics and Preventive Dentistry, Babu Banarasi Das College of Dental Sciences Lucknow in collaboration with Department of Pharmacology, King George Medical University Lucknow. Ninety six systemically healthy children (ASA type I) between 4-8 years of age for whom basic behaviour modification techniques were not successful in providing dental treatment were included in the study. Each parent/guardian was requested to fill a written informed consent form at the initial appointment. Data analysis was carried out using SPSS 16.0 version. Considering the efficacy parameter (duration, time of recovery) the intranasal dexmedetomidine (group 1, 2.5 µg/ kg) was found to be the better for procedural sedation. Intranasal administration with atomizer and nasal drop had no significant difference. Intranasal dexmedetomidine alone and in combination with nalbuphine showed comparable sedative efficacy with no additional advantage of combination over dexmedetomidine alone. Use of a commercially available atomizer showed improved patient’s acceptance of intranasal administered drugs but did not influence efficacy as compared to nasal drops.