scholarly journals Comparison of Intranasal Dexmedetomidine and Oral Midazolam for Premedication in Pediatric Dental Patients under General Anesthesia: A Randomised Clinical Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Li Wang ◽  
Lili Huang ◽  
Tiejun Zhang ◽  
Wei Peng
Keyword(s):  
Separation Anxiety ◽  
Pediatric Anesthesia ◽  
Pediatric Dentistry ◽  
Parental Separation ◽  
Hemodynamic Parameters ◽  
Emergence Delirium ◽  
Oral Midazolam ◽  
Significant Difference ◽  
Acceptance Scale ◽  
Parental Separation Anxiety

The aim of this study was to compare the effects of preoperative intranasal dexmedetomidine and oral midazolam on preoperative sedation and postoperative agitation in pediatric dentistry. A total of 60 children (ASA grade I, aged 3–6 years) scheduled for elective pediatric dental treatment were randomly divided into the dexmedetomidine (DEX) and midazolam (MID) groups. Ramsay sedation score, parental separation anxiety scale, mask acceptance scale, pediatric anesthesia emergence delirium scale, and hemodynamic parameters were recorded. The Ramsay sedation scale and hemodynamic parameters of the children were observed and recorded immediately before administration and 10, 20, and 30 min after administration. A satisfactory mask acceptance scale rate was 93.33% in both MID and DEX groups, and there was no significant difference between the two groups (p>0.05). The proportions of children that “successfully separated from their parents” were 93.33% (MID) and 96.67% (DEX). No significant difference was found between the two groups (p>0.05). The incidence of agitation was 20% in the MID group and 0% in the DEX group, and the difference was statistically significant (p<0.05). Intranasal dexmedetomidine and oral midazolam provided satisfactory sedation. No significant difference between the two groups was found in terms of parental separation anxiety and mask acceptance (p>0.05). The incidence of postoperative pediatrics emergence delirium was significantly lower in the DEX group (p<0.05).

scholarly journals The Effect of Oral Dexmedetomidine Premedication on Preoperative Cooperation and Emergence Delirium in Children Undergoing Dental Procedures

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Sultan Keles ◽  
Ozlem Kocaturk
Keyword(s):  
Apple Juice ◽  
Separation Anxiety ◽  
Pediatric Anesthesia ◽  
Control Group ◽  
Parental Separation ◽  
Hemodynamic Parameters ◽  
Emergence Delirium ◽  
Exact Test ◽  
Dental Procedures ◽  
Significant Difference

Introduction. The aim of this study was to detect the effect of 1 μg/kg of oral dexmedetomidine (DEX) as premedication among children undergoing dental procedures. Materials and Methods. The study involved 100 children between 2 and 6 years of age, ASA I, who underwent full-mouth dental rehabilitation. The DEX group (n=50) received 1 μg/kg DEX in apple juice, and the control group (n=50) received only apple juice. The patients’ scores on the Ramsay Sedation Scale (RSS), parental separation anxiety scale, mask acceptance scale, and pediatric anesthesia emergence delirium scale (PAEDS) and hemodynamic parameters were recorded. The data were analyzed using chi-square test, Fisher’s exact test, Student’s t-test, and analysis of variance in SPSS. Results. RSS scores were significantly higher in the DEX group than group C at 15, 30, and 45 min (p<0.05). More children (68% easy separation, 74% satisfactory mask acceptance) in the DEX group showed satisfactory ease of parental separation and mask acceptance behavior (p<0.05). There was no significant difference in the PAEDS scores and mean hemodynamic parameters of both groups. Conclusions. Oral DEX administered at 1 μg/kg provided satisfactory sedation levels, ease of parental separation, and mask acceptance in children but was not effective in preventing emergence delirium. The trial was registered (Protocol Registration Receipt NCT03174678) at clinicaltrials.gov.

scholarly journals A Comparative Study of Oral Dexmedetomidine versus Oral Midazolam As preanesthesia Medication in Pediatric Patients to Reduce anxiety

2019 ◽  
Vol 4 (2) ◽  
pp. 724-728
Author(s):  
Sabin Gauchan ◽  
Chitra Thapa ◽  
Abha Prasai
Keyword(s):  
General Anesthesia ◽  
Separation Anxiety ◽  
Elective Surgery ◽  
Sedation Score ◽  
Preoperative Anxiety ◽  
Parental Separation ◽  
Emergence Agitation ◽  
Oral Midazolam ◽  
Significant Difference ◽  
Group D

Introduction: Preoperative period is a stressful period. In children the preoperative anxiety is expressed as difficult separation from parents and difficult mask induction. The level of preoperative anxiety also affects postoperative outcomes. To overcome anxiety premedication is often used by pediatric anesthesiologist. Objective: The objective of this study was to compare the effect of oral midazolam 0.5mg/kg and oral dexmedetomidine 4μg/kg on parental separation, mask induction and postoperative emergence agitation in children undergoing elective surgery under general anesthesia. Methodology: 120 children aged 2-8years undergoing elective surgery under general anesthesia were divided into two groups: Group M and Group D. Patients in group M received oral midazolam 0.5mg/kg and patients in group D received oral dexmedetomidine 4μg/kg. After 45min of premedication sedation score was assessed in both the groups. Ease of parental separation and mask acceptance was compared in both the groups. In the postoperative period occurrence of emergence agitation was compared in both the groups. Results: There was no statistically significant difference in preoperative sedation score in both the groups. Parent separation anxiety score and mask acceptance score were statistically similar in both the groups. But emergence agitation was significantly lesser in patients who received dexmedetomidine premedication. Conclusions: Premedication with oral midazolam as well as oral dexmedetomidine effectively reduces parental separation anxiety and produces satisfactory mask induction in pediatric age group. However, dexmedetomidine is more effective in reducing emergence delirium in comparison to midazolam.

scholarly journals Intranasal midazolam versus intranasal dexmedetomidine as premedication in paediatric patients: A comparative study

2021 ◽  
Vol 8 (4) ◽  
pp. 532-536
Author(s):  
Vinayak Gour ◽  
Vimal Dangi ◽  
Sushil Chand Verma
Keyword(s):  
Separation Anxiety ◽  
Controlled Trial ◽  
Parental Separation ◽  
Paediatric Patients ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Preanesthetic Medication ◽  
Baseline Values ◽  
Randomised Controlled ◽  
Parental Separation Anxiety

: Preanesthetic medication is important among the paediatric patients undergoing surgeries. A good preanesthetic medication reduces the anxiety and the post-operative pain among paediatric patients. A randomised controlled trial was done to compare the two groups of Dexmedetomidine, and Midazolam given as preanesthetic medication intranasally.: Both the groups had comparable baseline values before premedication but there was a significant difference in the vital parameters of heart rate and systolic blood pressure after medication. The mean Parental Separation Anxiety Scale was found to be 1.4 ± 0.85 and 2.5 ± 0.98 among Dexmedetomidine and Midazolam group respectively. This was found to be significant (p &#60; 0.001). Dexmedetomidine when given as preanesthetic medication intranasally significantly controls the vitals within the normal range and produces better parental separation anxiety scores and mask acceptance scores as compared to Midazolam.

scholarly journals Comparison of sedative effects of oral midazolam/chloral hydrate and midazolam/promethazine in pediatric dentistry

2018 ◽  
Vol 12 (3) ◽  
pp. 221-226 ◽  
Author(s):  
Majid Mehran ◽  
Ghassem Ansari ◽  
Mojtaba Vahid Golpayegani ◽  
Shahnaz Shayeghi ◽  
Leila Shafiei
Keyword(s):  
Chloral Hydrate ◽  
Dental Treatment ◽  
Vital Signs ◽  
Pediatric Dentistry ◽  
Double Blind ◽  
Treatment Standard ◽  
Group I ◽  
Oral Midazolam ◽  
Significant Difference ◽  
Sedative Effects

Background. The aim of this investigation was to compare the sedative effects of oral midazolam/chloral hydrate and midazolam/promethazine combinations on fearful children needing dental treatment. Methods. This crossover double-blind clinical trial was conducted on 30 children aged 2‒6 years, who had at least two similar teeth needing pulp treatment. Standard vital signs were recorded before and after premedication. Wilson sedation scale was used to judge the level of sedation. Cases were divided into two groups based on the sequence of medication received. This was to overcome the sequence effect. Group I received oral midazolam (0.4 mg/kg/chloral hydrate (50 mg/kg) at the first visit while they received midazolam (0.4 mg/kg)/promethazine (5 mg/kg) in their second visit. Group II received the premedication in the opposite sequence. The operator and child were blinded to the medication administered. Sedative efficacy of the two combinations were assessed and judged by two independent pediatric dentists based on the Wilson scale. Data were analyzed with ANOVA and paired t-test. Results. Only 10% of children who received chloral hydrate with midazolam exhibited high improvement in their behavior while 53% showed reasonable positive changes and 12% had no change or even deterioration of behavior. The difference between the effect of the two combination drugs was statistically significant (P<0.05) in favor of the chloral hydrate group. Conclusion. The results showed a significant difference in the sedation level induced between the two groups. Midazolam/chloral hydrate combination more effectively improved the co-operation for dental treatment.

Development and Testing of a Scale to Measure Separation Anxiety of Parents of Adolescents

2008 ◽  
Vol 16 (1) ◽  
pp. 61-80 ◽  
Author(s):  
Carol J. Dashiff ◽  
Michael Weaver
Keyword(s):  
Internal Consistency ◽  
Maternal Separation ◽  
Separation Anxiety ◽  
Chronically Ill ◽  
Anxiety Scale ◽  
Parental Separation ◽  
Negatively Associated ◽  
Maternal Separation Anxiety ◽  
Cognitive Autonomy ◽  
Parental Separation Anxiety

Separation anxiety as an experience of parents of adolescents remains underinvestigated. The purpose of this study was to develop an instrument to assess parental separation anxiety of mothers and fathers of adolescent sons and daughters, that is, the Parental Separation Anxiety Scale (PSAS). The Maternal Separation Anxiety Scale was adapted to address this purpose. Three studies were conducted to assess item performance, internal consistency and test–retest reliability, and construct and predictive validity. Internal consistency reliability ranged from 0.91 to 0.93 across samples. Factor analysis indicated four factors with a primary factor (70% of variance) that was consistent with attachment theory. Parental separation anxiety was negatively associated with global relationship quality (r = –0.23, p = .01). Maternal separation anxiety was negatively associated with cognitive autonomy of sons (r = –0.34, p = .05), while paternal separation anxiety was positively associated with cognitive autonomy of daughters (r = 0.20, p = .05). It was concluded that the final 18-item PSAS has good psychometric qualities and is appropriate for use with parents of chronically ill and healthy adolescents.

scholarly journals The Effect of Dexmedetomidine on Emergence Agitation in Children After Desflurane Anesthesia

Acta Medica ◽  
2018 ◽  
Vol 49 (2) ◽  
pp. 1
Author(s):  
Filiz Banu Ethemoglu ◽  
Aysun Ankay Yilbas ◽  
Basak Akca ◽  
Hemra Cil ◽  
Ozgur Canbay
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Pediatric Anesthesia ◽  
Saline Group ◽  
Pain Scale ◽  
Control Group ◽  
Emergence Agitation ◽  
Emergence Delirium ◽  
Significant Difference ◽  
Duration Of Surgery

Objective: To evaluate the effect of dexmedetomidine on the emergence agitation in children after desflurane anesthesia. Materials-Methods: In this prospective  randomized comparative study, 50 children between the age group 2-10 years of American Society of Anesthesiologists physical status  I or II, who were scheduled for infrainguinal urologic surgery were enrolled and randomly divided into two groups. Group dexmedetomidine (Group B) (n=25) received 0.2 μg/kg dexmedetomidine in 10 ml saline intravenously over 10 minutes after induction and group control (Group A) (n=25) received only 10 ml saline infusion after induction. The emergence agitation levels of the children were evaluated according to the Pediatric Anesthesia Emergence Delirium Scale in the recovery room and postoperative pain scores were evaluated using Children’s and Infants’ Postoperative Pain Scale at the 10th and 30th minutes after extubation. Age, gender, weight, hemodynamic parameters, duration of anesthesia, duration of surgery and side effects were recorded.  Results: There was no significant difference in Pediatric Anesthesia Emergence Delirium scores at the 10th and 30th minutes after extubation between dexmedetomidine and saline groups. The decrease in emergence agitation at the 30th minute compared to the 10th minute was independent from sex, age and anesthesia duration in both groups. Incidence of hypotension and bradycardia was higher in the dexmedetomidine group compared to the saline group.  Conclusion: In children aged from two to 10 who undergo surgery with desflurane anesthesia, dexmedetomidine administration was not effective in preventing postoperative emergence agitation and caused increased side effects, such as hypotension and bradycardia. 

scholarly journals Child Care in Times of COVID-19: Predictors of Distress in Dutch Children and Parents When Re-entering Center-Based Child Care After a 2-Month Lockdown

2021 ◽  
Vol 12 ◽  
Author(s):  
Sanne M. de Vet ◽  
Claudia I. Vrijhof ◽  
Shelley M. C. van der Veek ◽  
Jane M. Pieplenbosch ◽  
Hedwig J. A. van Bakel ◽  
...  
Keyword(s):  
Child Care ◽  
Separation Anxiety ◽  
Care Center ◽  
Child Care Center ◽  
Parental Separation ◽  
Child Care Centers ◽  
Parental Distress ◽  
Children And Parents ◽  
Dutch Children ◽  
Parental Separation Anxiety

As a consequence of the outbreak of the Coronavirus Disease 2019 (COVID-19) child care facilities all over the world were temporarily closed to minimize the spread of the virus. In Netherlands, the first closure lasted for almost 2 months. The return to the child care center after this significant interruption was expected to be challenging, because earlier studies demonstrated that transitions into child care can be stressful for both children and their parents. The current paper retrospectively examined the distress of Dutch children (aged 0–4) and their parents during the first 2 weeks after the reopening of child care centers, and what factors accounted for individual differences in distress. In total, 694 parents filled out an online questionnaire about stress during closure and distress after the reopening of child care centers. Furthermore, questions regarding several demographic variables and child care characteristics were included, as well as questionnaires measuring child temperament, parental separation anxiety, and parental perception of the child care quality. Results showed that younger children and children with parents scoring higher on separation anxiety experienced more distress after the reopening, as reported by parents. Furthermore, children were more distressed upon return when they attended the child care center for less hours per week after the reopening, experienced less stress during closure, and grew up in a one-parent family. With regard to parental distress after the reopening, we found that parents scoring higher on separation anxiety and fear of COVID-19 experienced more distress. Moreover, parents experiencing less stress during closure and mothers were more distressed when the child returned to the child care center. Finally, concurrent child and parental distress after reopening were positively related. The results of the current study may help professional caregivers to identify which children and parents benefit from extra support when children return to the child care center after an interruption. Especially the role that parental separation anxiety played in predicting both child and parental distress deserves attention. More research is required in order to study the underlying mechanisms of these associations and to design appropriate interventions.

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