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Dexmedetomidina intranasale per grave ansia dentale: uno studio randomizzato

L'effetto ansiolitico della dexmedetomidina intranasale per i pazienti gravemente ansiosi nei trattamenti dentali

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.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Stimato)

30

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 18 anni a 65 anni (Adulto, Adulto più anziano)

Accetta volontari sani

Sì

Sessi ammissibili allo studio

Tutto

Descrizione

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.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Quadruplicare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: 0.8 μg/kg intranasal dexmedetomidine

Intranasal administration of 0.8 μg/kg dexmedetomidine

intranasal administration of dexmedetomidine

Altri nomi:
  • intranasale, studio controllato randomizzato, ansia dentale
Sperimentale: 1.5 μg/kg intranasal dexmedetomidine

Intranasal administration of 1.5 μg/kg dexmedetomidine

intranasal administration of dexmedetomidine

Altri nomi:
  • intranasale, studio controllato randomizzato, ansia dentale
Sperimentale: 2.0 μg/kg intranasal dexmedetomidine

Intranasal administration of 2.0 μg/kg dexmedetomidine

intranasal administration of dexmedetomidine

Altri nomi:
  • intranasale, studio controllato randomizzato, ansia dentale

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change of MDAS score
Lasso di tempo: 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

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change of plasma cortisol concentration
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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)
Lasso di tempo: 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)
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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.

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Investigatori

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

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

8 settembre 2026

Completamento primario (Stimato)

23 luglio 2028

Completamento dello studio (Stimato)

23 luglio 2028

Date di iscrizione allo studio

Primo inviato

2 agosto 2022

Primo inviato che soddisfa i criteri di controllo qualità

11 agosto 2022

Primo Inserito (Effettivo)

15 agosto 2022

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

30 settembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

27 settembre 2026

Ultimo verificato

1 luglio 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • SYSKY-2022-119-03

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

SÌ

Descrizione del piano IPD

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

Periodo di condivisione IPD

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

Criteri di accesso alla condivisione IPD

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

Tipo di informazioni di supporto alla condivisione IPD

  • STUDIO_PROTOCOLLO
  • LINFA
  • ICF
  • CODICE_ANALITICO
  • RSI

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .