The findings of a randomized, controlled, triple-blind clinical trial revealed that compared to the combination of dexmedetomidine and ketamine, the intranasal administration of dexmedetomidine alone is equally efficacious and satisfactory for sedation during dental procedures. It exhibits prompt recovery and fewer side effects in the outpatient setting. Researchers carried out the study to investigate the efficacy and safety of dexmedetomidine alone versus its combination with ketamine as a dental sedative for children (age 1-7 years).

The recruited 88 participants (44 per group; 50 boys) were randomly assigned into either dexmedetomidine and ketamine or dexmedetomidine groups. The children's behavior during sedation was the major endpoint that was systematically assessed as per the Ohio State University Behavioral Rating Scale (OSUBRS) via digital video records. Adverse events, recovery time, and dentist and parental satisfaction were the secondary outcomes.

Descriptive analysis of data was done through regression models. The duration of quiet behaviour was greater than 50%. Parents and dentists were completely satisfied. In 16 cases, side effects occurred and were found to be minor. The median recovery time in the dexmedetomidine and ketamine group was 1.3 times higher compared to the dexmedetomidine group, as illustrated in Table 1:

Thus, dexmedetomidine alone is similar to its combination with ketamine to sedate children requiring dental therapy. In addition, the dexmedetomidine and ketamine combination prolongs the post-anesthetic recovery.