title: Comparison of dexmedetomidine/fentanyl with midazolam/fentanyl combination for sedation and analgesia during tooth extraction.
abstract: Dexmedetomidine is an α2-adrenergic receptor agonist that causes minimal respiratory depression compared with alternative drugs. This study investigated whether combined dexmedetomidine/fentanyl offered better sedation and analgesia than midazolam/fentanyl in dental surgery. Sixty patients scheduled for unilateral impacted tooth extraction were randomly assigned to receive either dexmedetomidine and fentanyl (D/F) or midazolam and fentanyl (M/F). Recorded variables were patient preoperative anxiety scores, vital signs, visual analogue scale (VAS) pain scores, Observer's Assessment of Alertness/Sedation Scale (OAAS) scores after drug administration, surgeon and patient degree of satisfaction, and the duration of analgesia after surgery. The OAAS scores were significantly lower for patients administered D/F compared to those who received M/F. The duration of analgesia after the surgical procedure was significantly longer in patients who received D/F (5.3 h) than in those who received M/F (4.1 h; P=0.017). The number of surgeons satisfied with the level of sedation/analgesia provided by D/F was significantly higher than for M/F (P=0.001). Therefore, dexmedetomidine/fentanyl appears to provide better sedation, stable haemodynamics, surgeon satisfaction, and postoperative analgesia than midazolam/fentanyl during office-based unilateral impacted tooth extraction.
authors.affiliation: Department of Anesthesia, Stomatology Hospital, Chongqing Medical University, Chongqing, China. Electronic address: yucongab@sina.com.
authors.forename: C
authors.initials: C
authors.lastname: Yu
authors.affiliation: Department of Anesthesia, Stomatology Hospital, Chongqing Medical University, Chongqing, China.
authors.forename: S
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Anesthesia, Stomatology Hospital, Chongqing Medical University, Chongqing, China.
authors.forename: F
authors.initials: F
authors.lastname: Deng
authors.affiliation: Department of Anesthesia, Stomatology Hospital, Chongqing Medical University, Chongqing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Duke-NUS Graduate Medical School Singapore, Singapore.
authors.forename: L
authors.initials: L
authors.lastname: Qian
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D014081:Tooth Extraction / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid; D004338:Drug Combinations; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D008874:Midazolam; D005283:Fentanyl
keywords: analgesia; day surgery; dental surgery; dexmedetomidine; fentanyl; midazolam