Comparison between dexmedetomidine and esketamine in pediatric dentistry surgery

Background: Dexmedetomidine (D) and esketamine (K) are used for the sedation of pediatric dental surgery. This study was designed to compare the effect of intranasal D and K in producing moderate sedation for uncooperative pediatric dental patients. Methods: This prospective single-center cohort study was conducted at the Maternal and Child Health Hospital of Hubei Province after approval of the Medical Ethics Committee. One hundred and fifty American Society of Anesthesiologists (ASA) grade I and II patients aged 3-10 years who were uncooperative and could not be managed by conventional behavior management techniques were included in this study. Patients were classified into four groups. Group K was administered with esketamine (0.5 mg/kg), and group D was given D1 (1 mu g/kg), D2 (1.5 mu g/kg), or D3 (2.0 mu g/kg) intranasally. The outcome measurements included the sedation level, changes in vital signs, sedation onset and recovery times, analgesia, behavior, and overall success. Results: The sedation onset time was significantly shorter for K and D3 compared with D1 and D2. The recovery time was fastest in group D1. The overall success rate was highest in group D3, followed by the D2, D1, and K groups; however, the difference between them was not significant. The intra-and postoperative pain scores in the D3 and K groups were significantly lower than those in the D1 group. Conclusions: Intranasal D and K are effective in producing moderate sedation for uncooperative pediatric dental patients.