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重度の歯科不安に対するデクスメデトミジンの鼻腔内投与:ランダム化試験

歯科治療における重度の不安症患者に対する鼻腔内デクスメデトミジンの抗不安効果

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.

調査の概要

状態

まだ募集していません

条件

介入・治療

研究の種類

介入

入学 (推定)

30

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究連絡先のバックアップ

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年~65年 (大人、高齢者)

健康ボランティアの受け入れ

はい

受講資格のある性別

全て

説明

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.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:4倍

武器と介入

参加者グループ / アーム
介入・治療
実験的:0.8 μg/kg intranasal dexmedetomidine

Intranasal administration of 0.8 μg/kg dexmedetomidine

intranasal administration of dexmedetomidine

他の名前:
  • 鼻腔内、ランダム化比較試験、歯の不安
実験的:1.5 μg/kg intranasal dexmedetomidine

Intranasal administration of 1.5 μg/kg dexmedetomidine

intranasal administration of dexmedetomidine

他の名前:
  • 鼻腔内、ランダム化比較試験、歯の不安
実験的:2.0 μg/kg intranasal dexmedetomidine

Intranasal administration of 2.0 μg/kg dexmedetomidine

intranasal administration of dexmedetomidine

他の名前:
  • 鼻腔内、ランダム化比較試験、歯の不安

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Change of MDAS score
時間枠: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

二次結果の測定

結果測定
メジャーの説明
時間枠
Change of plasma cortisol concentration
時間枠: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
時間枠: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
時間枠: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)
時間枠: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)
時間枠: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
時間枠: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
時間枠: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.

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • 主任研究者:Zeman Qin, Master、Department of General Dentistry, Sun Yat-sen Memorial Hospital, Sun Yat-sen University

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

一般刊行物

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年9月8日

一次修了 (推定)

2028年7月23日

研究の完了 (推定)

2028年7月23日

試験登録日

最初に提出

2022年8月2日

QC基準を満たした最初の提出物

2022年8月11日

最初の投稿 (実際)

2022年8月15日

学習記録の更新

投稿された最後の更新 (実際)

2026年9月30日

QC基準を満たした最後の更新が送信されました

2026年9月27日

最終確認日

2026年7月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • SYSKY-2022-119-03

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD プランの説明

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

IPD 共有時間枠

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

IPD 共有アクセス基準

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

IPD 共有サポート情報タイプ

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • ANALYTIC_CODE
  • CSR

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

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