Comparison of the sedative effect of oral midazolam triclofos and dexmedetomidine in behaviour management of pediatric dental patients A Randomized Triple Blinded Clinical Trial

Abstract

newlineABSTRACT newlineBackground newlineManaging children in a dental operatory can be very challenging. The newlinebehavioural problems are mostly due to fear and anxiety towards dental newlinetreatment. Pharmacological behaviour management can be used when the child newlinefails to cooperate despite using the non pharmacological management newlinetechniques. Oral sedation has a slower onset of action as compared to other newlineroutes. Parents prefer this route for sedation as it less invasive as compared to newlineothers. Oral sedation does not require much advance training as well as newlineequipment as compared to the other techniques. A variety of drugs are used for newlineoral sedation in children that include Midazolam, Ketamine, dexmedetomidine, newlineTriclofos, Lorazepam and chloral hydrate. newlineAim newlineTo compare the sedative effect of oral midazolam, triclofos and newlinedexmedetomidine sedation in behaviour management of pediatric dental newlinepatients. newlineMaterials and Method newlineThe present study is a triple blinded randomized clinical study conducted newlinein 33 anxious children between the age group of 4 and 12 years of age requiring newlinetreatment under local anaesthesia under oral sedation. In group 1 the oral newlinesedative used was midazolam, in group 2, oral sedative used was triclofos and newlinein group 3 oral sedative used was dexmedetomidine. The influence on newlinebehaviour and the sedative effect of the oral sedative was assessed. Kruskal newlineWallis test was performed to compare the three groups. newlineResults newlineA total of 33 children participated in the study. The difference was found to be newlinesignificant with midazolam having a better influence on behaviour followed by newlinedexmedetomidine and then followed by triclofos and the difference was found to newlinebe statistically significant. (p=0.006) The difference was found to be significant newlinewith midazolam having better influence on the FLACC scale followed by newlinedexmedetomidine and then followed by triclofos and the difference was found to newlinebe statistically significant. (p=0.007) The difference was not statistically newlinesignificant between the groups based on their sedative effect.(p=0.58) newline