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Dexmédétomidine intranasale pour l'anxiété dentaire sévère : un essai randomisé

L'effet anxiolytique de la dexmédétomidine intranasale pour les patients très anxieux dans les traitements dentaires

Patients with dental anxiety only develop anxiety and fear about dental treatments. Patients with severe dental anxiety have difficulty cooperating with dental treatments, and can only complete dental treatments through general anesthesia, or even abandon treatments. Dexmedetomidine is a potent, highly selective α2-adrenoceptor agonist, which provides good anxiolytic, sedative and analgesic effects and is commonly used in anesthesiology and intensive care medicine departments, routinely intravenously. In recent years, intranasal administration of dexmedetomidine has also been reported for pediatric dentistry and adult alveolar surgery, showing good sedative and analgesic effects. However, these studies have problems such as single surgical types, small sample size, and few indicators analyzed. Therefore, the evaluation of intranasal administration of dexmedetomidine is still not comprehensive enough. Besides, the anxiolytic effect of dexmedetomidine for dental anxiety has not been reported yet. This project plans to carry out a randomized, double-blinded, placebo-controlled, two-stage clinical trial. We will firstly explore a reasonable dose, and secondly verify it with placebo as the control. We plan to measure the object indicators, including the NTI value, plasma cortisol, interleukin-6, blood pressure and heart rate, and to assess the subjective indicators using scales and questionnaires, thus comprehensively evaluating the effectiveness, safety and feasibility of the anxiolytic effect of intranasal dexmedetomidine for severe dental anxious patients, and preliminary exploring its mechanism additionally. We intend to help severe dental anxious patients completing dental treatments.

Aperçu de l'étude

Statut

Pas encore de recrutement

Les conditions

Intervention / Traitement

Type d'étude

Interventionnel

Inscription (Estimé)

30

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Sauvegarde des contacts de l'étude

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans à 65 ans (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Oui

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  1. Fully understand the purpose and significance of this trial, voluntarily participate in this clinical trial, and voluntarily sign an informed consent form;
  2. Age 18 to 65 years old, regardless of gender;
  3. Diagnosed by a dentist and needs dental treatment;
  4. Can be immediately arranged for dental treatment after being evaluated by the clinician as having no contraindications;
  5. Graded as severe dental anxious (obtained using the MDAS modified dental anxiety scale);
  6. 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;
  7. BMI is 18.5 kg/m2~25 kg/m2;
  8. After resting for 30 min, the SBP < 180 mmHg, the DBP < 110 mmHg, and the 60≤HR ≤ 120 bpm;
  9. 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:

  1. Subjects who are not considered by the researcher to be suitable for nasal drops (such as severe rhinitis, nasal malformations, etc.);
  2. Subjects with a history of severe arrhythmias such as type II or above AV block or a history of cardiac insufficiency;
  3. Subjects with a history of myocardial infarction or unstable angina in the 6 months before the screening period;
  4. Subjects with a history of ischemic stroke or transient ischemic attack (TIA);
  5. 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);
  6. 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;
  7. Subjects with a history of difficult airway disease or possibility, such as obstructive sleep apnea syndrome;
  8. 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%);
  9. Subjects who received selective alpha2-adrenoceptor agonists or antagonists within 14 days of randomization;
  10. Those who are allergic to dexmedetomidine hydrochloride or items used in stomatology;
  11. Pregnant or nursing women;
  12. 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;
  13. Other circumstances in which the investigator determines that the subject is not suitable to participate in this study.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Quadruple

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: 0.8 μg/kg intranasal dexmedetomidine

Intranasal administration of 0.8 μg/kg dexmedetomidine

intranasal administration of dexmedetomidine

Autres noms:
  • intranasal, essai contrôlé randomisé, anxiété dentaire
Expérimental: 1.5 μg/kg intranasal dexmedetomidine

Intranasal administration of 1.5 μg/kg dexmedetomidine

intranasal administration of dexmedetomidine

Autres noms:
  • intranasal, essai contrôlé randomisé, anxiété dentaire
Expérimental: 2.0 μg/kg intranasal dexmedetomidine

Intranasal administration of 2.0 μg/kg dexmedetomidine

intranasal administration of dexmedetomidine

Autres noms:
  • intranasal, essai contrôlé randomisé, anxiété dentaire

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Change of MDAS score
Délai: 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

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Change of plasma cortisol concentration
Délai: 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
Délai: 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
Délai: 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)
Délai: 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)
Délai: 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
Délai: 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
Délai: 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.

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: Zeman Qin, Master, Department of General Dentistry, Sun Yat-sen Memorial Hospital, Sun Yat-sen University

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

8 septembre 2026

Achèvement primaire (Estimé)

23 juillet 2028

Achèvement de l'étude (Estimé)

23 juillet 2028

Dates d'inscription aux études

Première soumission

2 août 2022

Première soumission répondant aux critères de contrôle qualité

11 août 2022

Première publication (Réel)

15 août 2022

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

30 septembre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

27 septembre 2026

Dernière vérification

1 juillet 2026

Plus d'information

Termes liés à cette étude

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

OUI

Description du régime IPD

All of the data will be shared after publication of the paper of this trial

Délai de partage IPD

The data will become available after the publication of the paper about this trial

Critères d'accès au partage IPD

IPD will be accessed by the Data and Safety Monitoring Committee and all researchers in related fields

Type d'informations de prise en charge du partage d'IPD

  • PROTOCOLE D'ÉTUDE
  • SÈVE
  • CIF
  • ANALYTIC_CODE
  • RSE

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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