Efficacy of Intranasal Dexmedetomidine for Conscious Sedation in Patients Undergoing Surgical Removal of Impacted Third Molar: A Double-Blind Split Mouth Study

Abstract

Background: This study was conducted to evaluate the utility and effectiveness of Intranasal Dexmedetomidine on Sedation status and pain experience of the patients undergoing surgical extraction of impacted third molar.

Materials and methods: In this double-blind, split mouth study, in 15 patients, evaluations pertaining to classes of third molar impaction was done. Each patient was randomly assigned to receive either intranasal normal saline (placebo group) or intranasal 1.5 µg/kg atomized Dexmedetomidine during the first session. The other regimen was used during the second session. Study was conducted for over a period of 120 min and data for sedation and pain was collected at an interval of 30 min. The collected data was then compared between the two groups within the same patient. Sedation status was assessed by a blinded observer with a modified Observer's Assessment of Alertness/Sedation (OAA/S) 13 scale (Annexure- B). Pain experience was evaluated by Visual Analog Scale (VAS) (Annexure-B). Clinical evaluation for sedation and pain was done by a blinded observer at 30, 60, 90, and 120 min after administration of the intranasal solution. The values were then tabulated, and compared between two visits.

Results: The mean values of OAA score of Dexmedetomidine group were significantly higher as compared to Placebo group with a 'p' value of 0.000. And the mean values of Pain score of Dexmedetomidine group were significantly lower as compared to Placebo group with a 'p' value 0.009.

Conclusion: The results of this study clearly indicated that: Intranasally administered Dexmedetomidine was significantly useful and effective to achieve optimal sedation and analgesia during third molar surgery.

Keywords: Dexmedetomidine; Intranasal sedation; Third molar extraction.

Conflict of interest statement

Dr. Sujeeth K. Shetty and Dr. Garima declare that they have no conflict of interest. Ethical Approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution. Informed Consent Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1

Intranasal delivery of solution

Fig. 2

Surgical Extraction of Mandibular third molar

Graph 1

Mean values of sedation as analyzed by modified observer’s assessment of alertness/sedation scale

Graph 2

Mean values of pain score as analyzed VAS

Fig. 3

Mucosal atomization device (MAD)