{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T03:33:02Z","timestamp":1787887982755,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pharmacological methods, specifically sedatives, have gained popularity in managing the behavior of children during dental appointments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>The aim of this study was to compare 1 m\/kg intranasal dexmedetomidine, 0.3 mg\/kg intranasal midazolam, and nitrous oxide in evaluating the level of sedation, behavior of the child, onset of sedation, physiologic signs, and adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>In this cross-over trial, 15 children aged 6\u20138 years were randomized to receive intranasal atomized dexmedetomidine, intranasal atomized midazolam, and inhalation nitrous oxide at three separate visits. After administering the sedative agent, a single pulpectomy was performed during each appointment, and the outcomes were recorded. The washout period between each visit was 1 week.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All three sedative agents were equally effective in controlling overall behavior. Dexmedetomidine showed lower sedation level scores (agitated; score 9) than the other groups. There was a statistically significant difference in the onset of sedation, with dexmedetomidine having the longest onset of 36.2 \u00b1 9.47 min. Coughing and sneezing were predominantly observed after administration of intranasal midazolam. Oxygen saturation levels were statistically lower in the intranasal midazolam group during local anesthesia administration and post-treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>0.3 mg\/kg intranasal midazolam is as effective as nitrous oxide sedation for controlling behavior and providing adequate sedation in pediatric dental patients. However, 1 m\/kg dexmedetomidine did not provide the same level of sedation and had a significantly longer onset. 0.3 mg\/kg intranasal midazolam is an effective alternative to nitrous oxide sedation in anxious children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jisppd.jisppd_104_24","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T05:01:20Z","timestamp":1719982880000},"page":"141-148","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Comparative evaluation of intranasal dexmedetomidine, intranasal midazolam, and nitrous oxide for conscious sedation of anxious children undergoing dental treatment: A randomized cross-over trial"],"prefix":"10.4103","volume":"42","author":[{"given":"Palak","family":"Janiani","sequence":"first","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepa","family":"Gurunathan","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramsesh","family":"Manohar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,6,28]]},"reference":[{"key":"R3-20240905","first-page":"CD003877","article-title":"Sedation of children undergoing dental treatment","volume":"12","author":"Ashley","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"R5-20240905","doi-asserted-by":"crossref","first-page":"83","DOI":"10.17245\/jdapm.2019.19.2.83","article-title":"Role of dexmedetomidine in pediatric dental sedation","volume":"19","author":"Mohite","year":"2019","journal-title":"J Dent Anesth Pain Med"},{"key":"R6-20240905","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1186\/s13063-023-07767-2","article-title":"Comparison of S-ketamine and midazolam for intravenous preoperative sedative and anxiolytic effects in preschool children:Study protocol for a randomized controlled clinical trial","volume":"24","author":"Zhang","year":"2023","journal-title":"Trials"},{"key":"R8-20240905","doi-asserted-by":"crossref","first-page":"105","DOI":"10.4103\/ccd.ccd_470_20","article-title":"Sedative and behavioral effects of intranasal midazolam in comparison with other administrative routes in children undergoing dental treatment \u2013A systematic review","volume":"12","author":"Preethy","year":"2021","journal-title":"Contemp Clin Dent"},{"key":"R9-20240905","doi-asserted-by":"crossref","first-page":"255","DOI":"10.17796\/jcpd.38.3.l828585807482966","article-title":"A comparative evaluation of intranasal dexmedetomidine, midazolam and ketamine for their sedative and analgesic properties:A triple blind randomized study","volume":"38","author":"Surendar","year":"2014","journal-title":"J Clin Pediatr Dent"},{"key":"R10-20240905","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1213\/ane.0b013e31816c8929","article-title":"A comparison of intranasal dexmedetomidine and oral midazolam for premedication in pediatric anesthesia:A double-blinded randomized controlled trial","volume":"106","author":"Yuen","year":"2008","journal-title":"Anesth Analg"},{"key":"R11-20240905","first-page":"S111","article-title":"Comparison of the sedative effect of inhaled nitrous oxide and intranasal midazolam in behavior management and pain perception of pediatric patients:A split-mouth randomized controlled clinical trial","volume":"14","author":"Srinivasan","year":"2021","journal-title":"Int J Clin Pediatr Dent"},{"key":"R13-20240905","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4103\/0970-4388.50810","article-title":"Comparison of oral midazolam with a combination of oral midazolam and nitrous oxide-oxygen inhalation in the effectiveness of dental sedation for young children","volume":"27","author":"Al-Zahrani","year":"2009","journal-title":"J Indian Soc Pedod Prev Dent"},{"key":"R14-20240905","doi-asserted-by":"crossref","first-page":"7","DOI":"10.4103\/0970-4388.22830","article-title":"Conscious sedation \u2013An artist's science!An Indian experience with midazolam","volume":"24","author":"Shashikiran","year":"2006","journal-title":"J Indian Soc Pedod Prev Dent"},{"key":"R15-20240905","doi-asserted-by":"crossref","first-page":"189","DOI":"10.21037\/atm-20-5177","article-title":"Intranasal drugs for analgesia and sedation in children admitted to pediatric emergency department:A narrative review","volume":"9","author":"Pansini","year":"2021","journal-title":"Ann Transl Med"},{"key":"R16-20240905","first-page":"301","article-title":"Assessment of two doses of intranasal midazolam for sedation of young pediatric dental patients","volume":"16","author":"Fuks","year":"1994","journal-title":"Pediatr Dent"},{"key":"R17-20240905","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1111\/j.1460-9592.2004.01349.x","article-title":"Paradoxical reaction following intravenous midazolam premedication in pediatric patients \u2013A randomized placebo controlled trial of ketamine for rapid tranquilization","volume":"14","author":"Golparvar","year":"2004","journal-title":"Paediatr Anaesth"},{"key":"R18-20240905","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2023\/6655628","article-title":"Influence of temperament on the acceptance of two conscious sedation techniques in toddlers undergoing dental treatment:A randomised cross over trial","volume":"2023","author":"Janiani","year":"2023","journal-title":"Pain Res Manag"},{"key":"R19-20240905","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1111\/pan.12287","article-title":"Intranasal dexmedetomidine versus midazolam for premedication in children undergoing complete dental rehabilitation:A double-blinded randomized controlled trial","volume":"24","author":"Sheta","year":"2014","journal-title":"Paediatr Anaesth"},{"key":"R20-20240905","doi-asserted-by":"crossref","first-page":"233","DOI":"10.4103\/jisppd.jisppd_517_20","article-title":"Comparison of the safety and efficacy of dexmedetomidine with midazolam for the management of paediatric dental patients:A systematic review","volume":"39","author":"Goswami","year":"2021","journal-title":"J Indian Soc Pedod Prev Dent"},{"key":"R21-20240905","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1046\/j.1365-263x.2001.00237.x","article-title":"Intra-nasal midazolam in conscious sedation of young paediatric dental patients","volume":"11","author":"al-Rakaf","year":"2001","journal-title":"Int J Paediatr Dent"},{"key":"R22-20240905","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s40368-015-0187-7","article-title":"A comparison of the sedative effect of oral versus nasal midazolam combined with nitrous oxide in uncooperative children","volume":"16","author":"Musani","year":"2015","journal-title":"Eur Arch Paediatr Dent"},{"key":"R23-20240905","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1097\/PEC.0b013e31823aff6d","article-title":"Safety of high-concentration nitrous oxide by nasal mask for pediatric procedural sedation:Experience with 7802 cases","volume":"27","author":"Zier","year":"2011","journal-title":"Pediatr Emerg Care"},{"key":"R24-20240905","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1111\/j.1365-2044.2007.05260.x","article-title":"The use of intranasal midazolam in the treatment of paediatric dental patients","volume":"62","author":"Gilchrist","year":"2007","journal-title":"Anaesthesia"},{"key":"R25-20240905","doi-asserted-by":"crossref","first-page":"415","DOI":"10.17796\/jcpd.35.4.l43h3354705u2574","article-title":"A comparative evaluation of intranasal midazolam, ketamine and their combination for sedation of young uncooperative pediatric dental patients:A triple blind randomized crossover trial","volume":"35","author":"Bahetwar","year":"2011","journal-title":"J Clin Pediatr Dent"}],"container-title":["Journal of Indian Society of Pedodontics and Preventive Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jisppd.jisppd_104_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:53:57Z","timestamp":1787838837000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jisppd.jisppd_104_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/jisppd.jisppd_104_24","relation":{},"ISSN":["0970-4388","1998-3905"],"issn-type":[{"value":"0970-4388","type":"print"},{"value":"1998-3905","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2024-03-19","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}