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Intranasal dexmedetomidin for alvorlig tannlegeangst: en randomisert prøvelse

Den angstdempende effekten av intranasal deksmedetomidin for alvorlig engstelige pasienter i tannbehandlinger

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.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

30

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 65 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Ja

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Firemannsrom

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 0.8 μg/kg intranasal dexmedetomidine

Intranasal administration of 0.8 μg/kg dexmedetomidine

intranasal administration of dexmedetomidine

Andre navn:
  • intranasal, randomisert kontrollert studie, tannlegeangst
Eksperimentell: 1.5 μg/kg intranasal dexmedetomidine

Intranasal administration of 1.5 μg/kg dexmedetomidine

intranasal administration of dexmedetomidine

Andre navn:
  • intranasal, randomisert kontrollert studie, tannlegeangst
Eksperimentell: 2.0 μg/kg intranasal dexmedetomidine

Intranasal administration of 2.0 μg/kg dexmedetomidine

intranasal administration of dexmedetomidine

Andre navn:
  • intranasal, randomisert kontrollert studie, tannlegeangst

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change of MDAS score
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change of plasma cortisol concentration
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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.

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Etterforskere

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

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

8. september 2026

Primær fullføring (Antatt)

23. juli 2028

Studiet fullført (Antatt)

23. juli 2028

Datoer for studieregistrering

Først innsendt

2. august 2022

Først innsendt som oppfylte QC-kriteriene

11. august 2022

Først lagt ut (Faktiske)

15. august 2022

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

30. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

27. september 2026

Sist bekreftet

1. juli 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • SYSKY-2022-119-03

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

JA

IPD-planbeskrivelse

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

IPD-delingstidsramme

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

Tilgangskriterier for IPD-deling

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

IPD-deling Støtteinformasjonstype

  • STUDY_PROTOCOL
  • SEVJE
  • ICF
  • ANALYTIC_CODE
  • CSR

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .