International dental journal · 2026
The Efficacy and Safety of Intranasal Dexmedetomidine Spray Followed by Nitrous Oxide for Paediatric Oral Procedures.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Xiao Yu-Jie, Zhang Hong-Yu, Nie Meng-Di, Liu Guo-Sheng, Peng Wei, Zhao Ji-Hong, Hu Zhen-Hao, Sun Huan, Wu Yang
Аннотация
INTRODUCTION AND AIMS: The management of uncooperative children requiring complex outpatient oral procedures presents a significant clinical challenge. This study aimed to evaluate the safety and efficacy of intranasal dexmedetomidine (DEX) spray combined with nitrous oxide/oxygen (N₂O/O₂) inhalation sedation for the extraction of impacted supernumerary teeth in paediatric patients.
METHODS: This retrospective clinical study enrolled uncooperative children aged 6 to 12 years (Frankl Scale score 2-3). Preoperative sedation was achieved using 2 µg/kg intranasal DEX spray. After sedation onset, heart rate (HR), blood pressure (BP), and oxygen saturation (SpO₂) were monitored. Throughout the procedure, N₂O/O₂ inhalation was administered to maintain a moderate sedation level, with HR, BP, SpO₂, and sedation depth recorded at 5-minute intervals. Postoperatively, patients were observed in the recovery room until all discharge criteria were met.
RESULTS: All 63 patients (34 boys and 29 girls) cooperated with nasal hood placement and successfully underwent parental separation. Sixty children (95.24%) completed the procedure successfully, with 56 (88.89%) maintaining moderate sedation depth throughout. There were significant decreases in HR and BP (P < .001), while SpO₂ (P = .120) remained stable during procedures. Adverse events included drowsiness (5 cases, 7.94%), dizziness (2 cases, 3.17%), and hypotension (8 cases, 12.70%). Only one (1.59%) case experienced hypoxemia concurrently presenting with bradycardia and hypotension, which required brief clinical intervention.
CONCLUSION: The combination of intranasal DEX spray and N₂O/O₂ appears to be a promising sedation technique for impacted supernumerary tooth extraction in paediatric patients, with minimal adverse effects rarely requiring clinical intervention.
CLINICAL RELEVANCE: This protocol shows promise in addressing the challenge of non-cooperation prior to N₂O administration, and may offer an effective, convenient, and relatively safe approach for managing uncooperative paediatric patients undergoing complex oral surgery.
METHODS: This retrospective clinical study enrolled uncooperative children aged 6 to 12 years (Frankl Scale score 2-3). Preoperative sedation was achieved using 2 µg/kg intranasal DEX spray. After sedation onset, heart rate (HR), blood pressure (BP), and oxygen saturation (SpO₂) were monitored. Throughout the procedure, N₂O/O₂ inhalation was administered to maintain a moderate sedation level, with HR, BP, SpO₂, and sedation depth recorded at 5-minute intervals. Postoperatively, patients were observed in the recovery room until all discharge criteria were met.
RESULTS: All 63 patients (34 boys and 29 girls) cooperated with nasal hood placement and successfully underwent parental separation. Sixty children (95.24%) completed the procedure successfully, with 56 (88.89%) maintaining moderate sedation depth throughout. There were significant decreases in HR and BP (P < .001), while SpO₂ (P = .120) remained stable during procedures. Adverse events included drowsiness (5 cases, 7.94%), dizziness (2 cases, 3.17%), and hypotension (8 cases, 12.70%). Only one (1.59%) case experienced hypoxemia concurrently presenting with bradycardia and hypotension, which required brief clinical intervention.
CONCLUSION: The combination of intranasal DEX spray and N₂O/O₂ appears to be a promising sedation technique for impacted supernumerary tooth extraction in paediatric patients, with minimal adverse effects rarely requiring clinical intervention.
CLINICAL RELEVANCE: This protocol shows promise in addressing the challenge of non-cooperation prior to N₂O administration, and may offer an effective, convenient, and relatively safe approach for managing uncooperative paediatric patients undergoing complex oral surgery.