Anesthesia & Clinical Research
Open Access

Abstract

Dexmedetomidine: A Preliminary Exploration of its Safety and Efficacy in Pediatric Dental Setting

Neeti Mittal, Binita Srivastava and Khushtar Haider

Objective: To report on safety and efficacy of intravenous usage of Dexmedetomidine for endodontic intervention in young and anxious pediatric patients.

Methods: This prospective pilot investigation enrolled 10 healthy ASA status I, 2-6 year old children who were anxious (Venham’s score ≥ 4) and were scheduled to undergo primary molar pulpectomy under sedation. Sedation induction was done with 1 mg/kg of propofol bolus followed by 0.2-0.8 µg/kg of dexmedetomidine infusion for maintenance. Sedation was titrated to achieve Houpt’s overall behavior score of ≥ 4. In case of insufficient sedation, rescue propofol boluses (1 mg/kg) were administered. Vitals were monitored every 5 minutes and recovery was evaluated using Alderete Modified Post Anesthesia Discharge Scoring System. Adverse events, i.e., ≥ ± 20% baseline fluctuations in vital signs, tachycardia, bradycardia, apnea, desaturation, stridor and/or laryngospasm were recorded.

Results: The procedure was successfully completed in all of the subjects with the current sedation regime as per the study protocol. Rescue propofol boluses were needed in 8 subjects. No untoward fluctuations in vital signs or adverse events were reported in either intra-operative phase or post-operatively.

Conclusion: Intravenous Dexmedetomidine is safe and efficient sedative for endodontic intervention in young and anxious pediatric patients.