Comparative Evaluation of Intranasal Dexmedetomidine-Ketamine, Ketamine-Midazolam and Nitrous oxide-Oxygen inhalation for conscious sedation of 5-10 year old Anxious Children Undergoing Dental Treatment: A Randomised Clinical Trial

Any medical or dental procedure aims to complete treatment with least or no discomfort. In pediatric patiets , anxiety and fear are the most common reasons for difficulty in behaviour management.There are two different kinds of behaviour management techniques - non pharmacological and pharmacological.When non pharmacological behvaiour management techniques fail , pharmacological sedatives are used as alternatives.There are various drugs and routes of administration employed.In this study the intranasal route is opted as it is non-invasive ,less traumatic to pediatric patients and has faster onset as it bypassess the first pass metabolism.Previous literature showed evidence of individual drugs used for intranasal sedation . In this study combination of such drugs(dexmedetomidine-ketamine and ketamine-midazolam) are used to check if there are any added advantages such as faster onset of sedation and recovery.And also to check if one drug overcomes the disadvantage of another.For example, midazolam casues bradycardia ad ketamine causes tachycardia,the combination might cause a nullification of the individual effects.