Ketamine plus dexmedetomidine (ketodex) vs remifentanil plus midazolam for sedation in dental procedures

Abstract

Sedation is a technique used to reduce anxiety and pain during dental procedures. In recent years, new drugs have been developed, such as ketamine and dexmedetomidine in combination. Aim. To evaluate the level of sedoanalgesia of ketamine plus dexmedetomidine (ketodex) vs remifentanil plus midazolam for dental procedures. Methodology: Two groups were divided: Midazolam + Remifentanil (group A) and Ketamine + Dexmedetomidine (group B). Experimental study, longitudinal, prospective, observational, descriptive and comparative. The population, ASA I, II or III patients over 18 years of age. Sample of 20 patients, selected randomly. Group A received Midazolam 0.03-0.07 mg/kg/dose and Remifentanil 0.05-0.1 mg/kg/min infusion. Group B received Dexmedetomidine 0.5 μg/kg boluses plus Ketamine 0.5 mg/kg boluses, and maintenance with Dexmedetomidine 0.1-0.2 mcg/kg every 10-15 minutes. Data are analyzed using descriptive and inferential statistics and support of the Rstudio program. Results. There were no significant differences between the two groups in terms of the level of sedation (p=0.146), use of Propofol as a rescue hypnotic, or level of pain during the procedure (p=0.189). However, the differences were; Group A had a higher heart rate than group B in all measurements. Group B had a higher systolic blood pressure (SBP) than group A (p=0.006957). The number of complications at the end of the study was greater for group B. Conclusion. Overall, the study results suggest that the ketodex combination is a safe and effective option for sedation in adult patients undergoing dental procedures.