Intranasal Dexmedetomidine for Severe Dental Anxiety: a Randomized Trial
The Anxiolytic Effect of Intranasal Dexmedetomidine for Severely Anxious Patients in Dental Treatments
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Zeman Qin, Master
- Phone Number: 15018419746
- Email: qinzm@mail.sysu.edu.cn
Study Contact Backup
- Name: Liushan Ou, Master
- Phone Number: 020-81332587
- Email: sysyxllwyh@163.com
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Fully understand the purpose and significance of this trial, voluntarily participate in this clinical trial, and voluntarily sign an informed consent form;
- Age 18 to 65 years old, regardless of gender;
- Diagnosed by a dentist and needs dental treatment;
- Can be immediately arranged for dental treatment after being evaluated by the clinician as having no contraindications;
- Graded as severe dental anxious (obtained using the MDAS modified dental anxiety scale);
- After controlling the symptoms of infection if with symptoms of acute/systemic infection, and can be arranged immediately after meeting the indications for dental treatments;
- BMI is 18.5 kg/m2~25 kg/m2;
- After resting for 30 min, the SBP < 180 mmHg, the DBP < 110 mmHg, and the 60≤HR ≤ 120 bpm;
- For women who have not been menopausal or who have been under 1 year of menopause, a pregnancy test (blood or urine pregnancy test) should be performed during the screening period, and then the study and administration should be carried out after the pregnancy test is negative during the screening period.
Exclusion Criteria:
- Subjects who are not considered by the researcher to be suitable for nasal drops (such as severe rhinitis, nasal malformations, etc.);
- Subjects with a history of severe arrhythmias such as type II or above AV block or a history of cardiac insufficiency;
- Subjects with a history of myocardial infarction or unstable angina in the 6 months before the screening period;
- Subjects with a history of ischemic stroke or transient ischemic attack (TIA);
- Subjects with poor blood pressure control after drug therapy (hypertension: SBP≥180 mmHg, and/or DBP≥110 mmHg, or hypotension: SBP <90 mmHg and/or DBP≤50 mmHg);
- Subjects with psychiatric disorders (such as schizophrenia, anxiety, depression, etc.) and cognitive dysfunction, or have a history of epilepsy, or previous abuse of psychotropic drugs and narcotic drugs;
- Subjects with a history of difficult airway disease or possibility, such as obstructive sleep apnea syndrome;
- Randomly, within 1 year of random, a history of drug abuse, a history of drug abuse and a history of alcohol abuse, i.e., a subject who drank more than 2 units of alcohol per day on average (1 unit = 360 ml of beer or 45 ml of liquor or 150 ml of wine with an alcohol content of 40%);
- Subjects who received selective alpha2-adrenoceptor agonists or antagonists within 14 days of randomization;
- Those who are allergic to dexmedetomidine hydrochloride or items used in stomatology;
- Pregnant or nursing women;
- Those who have a birth plan within 30 days before the screening period and half a year after the end of the trial, and are unwilling or unable to take effective contraception measures;
- Other circumstances in which the investigator determines that the subject is not suitable to participate in this study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: QUADRUPLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: 0.8 μg/kg intranasal dexmedetomidine
Intranasal administration of 0.8 μg/kg dexmedetomidine
|
intranasal administration of dexmedetomidine
Other Names:
|
|
EXPERIMENTAL: 1.5 μg/kg intranasal dexmedetomidine
Intranasal administration of 1.5 μg/kg dexmedetomidine
|
intranasal administration of dexmedetomidine
Other Names:
|
|
EXPERIMENTAL: 2.0 μg/kg intranasal dexmedetomidine
Intranasal administration of 2.0 μg/kg dexmedetomidine
|
intranasal administration of dexmedetomidine
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change of MDAS score
Time Frame: Change from baseline MDAS score right after finishing dental treatments, an average of 30 minutes
|
Dental anxious score will be accessed by modified dental anxiety scale (MDAS), and the change of MDAS score will be calculated as the scores right after dental treatments minus the initial score before intervention.
|
Change from baseline MDAS score right after finishing dental treatments, an average of 30 minutes
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change of plasma cortisol concentration
Time Frame: Change from baseline plasma cortisol concentration right after finishing dental treatments, an average of 30 minutes
|
The change of plasma cortisol concentration will be calculated as the values right after dental treatments minus the initial values before intervention.
|
Change from baseline plasma cortisol concentration right after finishing dental treatments, an average of 30 minutes
|
|
Change of NTI score
Time Frame: Change from baseline NTI score right after finishing dental treatments, an average of 30 minutes
|
The depth of sedation will be accessed by NTI score using Narcotrend, and the change of NTI score will be calculated as the score right after dental treatments minus the initial score before intervention.
|
Change from baseline NTI score right after finishing dental treatments, an average of 30 minutes
|
|
Change of OAA/S score
Time Frame: Change from baseline OAA/S score right after finishing dental treatments, an average of 30 minutes
|
OAA/S score will be accessed by observer's assessment of alertness/sedation scale (OAA/S), which also represent the depth of sedation, and the change of OAA/S score will be calculated as the score right after dental treatments minus the initial score before intervention.
|
Change from baseline OAA/S score right after finishing dental treatments, an average of 30 minutes
|
|
Change of blood pressure (BP)
Time Frame: Change from baseline BP right after finishing dental treatments, an average of 30 minutes.
|
BP will be continuously accessed using an electrocardiogram monitor throughout the whole clinical process.
BP value will be converted into mean arterial pressure (MAP) for comparison using the formula: MAP = (SBP + 2 × DBP)/3.
Then the change of BP was presented as ΔMAP, which was calculated as the MAP at the point with the highest SBP minus the initial MAP right before the procedure.
|
Change from baseline BP right after finishing dental treatments, an average of 30 minutes.
|
|
Change of heart rate (HR)
Time Frame: Change from baseline HR right after finishing dental treatments, an average of 30 minutes.
|
HR will be continuously accessed using an electrocardiogram monitor throughout the whole clinical process.
Change of HR equaled the corresponding HR of the highest SBP subtracted by the initial HR.
|
Change from baseline HR right after finishing dental treatments, an average of 30 minutes.
|
|
Pain score
Time Frame: Through the completion of dental treatments, an average of 30 minutes.
|
Pain score will be obtained via visual analogue scale (MDAS) for the subject to fill.
|
Through the completion of dental treatments, an average of 30 minutes.
|
|
Percentage of thinking feasible of intranasal dexmedetomidine by participants
Time Frame: Through the completion of dental treatments, an average of 30 minutes.
|
The feasibility of intranasal dexmedetomidine will be assessed through semistructured questionnaires.
Items includes the reasons for nonparticipation; the acceptability of the trial and intranasal dexmedetomidine to participants; and the experience of the patients, the clinician performing the procedure, and the nursing staff taking care for patients during the study.
The patients and clinic staffs filled the questionnaires right after the extraction process under our instruction.
The outcome of the questionnaires was analyzed through counting and reported as a percentage (%).
|
Through the completion of dental treatments, an average of 30 minutes.
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Zeman Qin, Master, Department of General Dentistry, Sun Yat-sen Memorial Hospital, Sun Yat-sen University
Publications and helpful links
General Publications
- Uusalo P, Guillaume S, Siren S, Manner T, Vilo S, Scheinin M, Saari TI. Pharmacokinetics and Sedative Effects of Intranasal Dexmedetomidine in Ambulatory Pediatric Patients. Anesth Analg. 2020 Apr;130(4):949-957. doi: 10.1213/ANE.0000000000004264.
- Yoo H, Iirola T, Vilo S, Manner T, Aantaa R, Lahtinen M, Scheinin M, Olkkola KT, Jusko WJ. Mechanism-based population pharmacokinetic and pharmacodynamic modeling of intravenous and intranasal dexmedetomidine in healthy subjects. Eur J Clin Pharmacol. 2015 Oct;71(10):1197-207. doi: 10.1007/s00228-015-1913-0. Epub 2015 Aug 2.
- Coursin DB, Coursin DB, Maccioli GA. Dexmedetomidine. Curr Opin Crit Care. 2001 Aug;7(4):221-6. doi: 10.1097/00075198-200108000-00002.
- Shetty SK, Aggarwal G. Efficacy of Intranasal Dexmedetomidine for Conscious Sedation in Patients Undergoing Surgical Removal of Impacted Third Molar: A Double-Blind Split Mouth Study. J Maxillofac Oral Surg. 2016 Dec;15(4):512-516. doi: 10.1007/s12663-016-0889-3. Epub 2016 Apr 21.
- Nooh N, Sheta SA, Abdullah WA, Abdelhalim AA. Intranasal atomized dexmedetomidine for sedation during third molar extraction. Int J Oral Maxillofac Surg. 2013 Jul;42(7):857-62. doi: 10.1016/j.ijom.2013.02.003. Epub 2013 Mar 14.
- Cheung CW, Ng KF, Liu J, Yuen MY, Ho MH, Irwin MG. Analgesic and sedative effects of intranasal dexmedetomidine in third molar surgery under local anaesthesia. Br J Anaesth. 2011 Sep;107(3):430-7. doi: 10.1093/bja/aer164. Epub 2011 Jun 16.
- Liu S, Wang Y, Zhu Y, Yu T, Zhao H. Safety and sedative effect of intranasal dexmedetomidine in mandibular third molar surgery: a systematic review and meta-analysis. Drug Des Devel Ther. 2019 Apr 23;13:1301-1310. doi: 10.2147/DDDT.S194894. eCollection 2019.
- Ryu DS, Lee DW, Choi SC, Oh IH. Sedation Protocol Using Dexmedetomidine for Third Molar Extraction. J Oral Maxillofac Surg. 2016 May;74(5):926.e1-7. doi: 10.1016/j.joms.2015.12.021. Epub 2016 Jan 7.
Study record dates
Study Major Dates
Study Start (ANTICIPATED)
Study Start
Primary Completion (ANTICIPATED)
Primary Completion
Study Completion (ANTICIPATED)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ACTUAL)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Anxiety Disorders
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Analgesics, Non-Narcotic
- Adrenergic alpha-2 Receptor Agonists
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Hypnotics and Sedatives
- Dexmedetomidine
Other Study ID Numbers
Other Study ID Numbers
- SYSKY-2022-119-03
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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