INTRANASAL DEXMEDETOMIDINE AS CONSCIOUS SEDATION IN SURGICAL EXTRACTION OF IMPACTED TEETH

Abstract

BACKGROUND & OBJECTIVES

The handling of a patient's worry and concern before surgery has long been an important aspect of patient care. Conscious sedation techniques can considerably reduce the need for general anaesthesia for minor oral surgical operations. Among different drugs used for conscious sedation, Dexmedetomidine is chosen because it causes less respiratory depression, easy arousal of the patient and analgesic sparing properties. Use of Intranasal medications for dental procedures is easy and effective. The nasal Atomiser device delivers intranasal medication in a fine mist which ensures the exact dose and volume delivered, enhances absorption improves bioavailability for fast and effective drug delivery.

METHOD

The study was carried out in 10 patients. Patients with impacted mandibular third molars were chosen for the study. All the patients were administered intranasal Dexmedetomidine, through Mucosal Automiser Device 30 mins before the procedure. Patients were evaluated for Sedation and Pain, Sedation at 30 mins and 60 mins intra operatively using Observer’s Assessment of Alertness/Sedation (OAA/ S) and Pain at baseline and 30 mins and 60 mins intra operatively using Visual Analogue Scale. Patient’s vitals such as Blood Pressure, Heart Rate and Oxygen Saturation was monitored continuously.

RESULTS

All cases showed significant sedation (p<0.05) with OAA/S score at 30 mins intra-operatively. In two out of ten patients, VAS score was reduced at 60mins.

CONCLUSION

This study aimed to evaluate the efficacy of Intranasal Dexmedetomidine for achieving conscious sedation in patients. Significant Sedation (p<0.05) was achieved at 30mins intraoperatively. Hence we conclude by saying that, Dexmedetomidine given intranasally is a non-invasive and effective way to achieve sedation in patients undergoing procedures under local anesthesia in order to reduce the anxiety of the patient related to the procedure.