Evidence map›Paper›PMID 40604736›Full record

ArticleBMC oral health2025

Deep sedation using intranasal dexmedetomidine followed by intravenous propofol for pediatric dental treatment.

Yun Liu, Binghua Li, Xiaoran Wu, Bin Xia, Xudong Yang, Tong Cheng

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Observational
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Yun Liu *Department of Anesthesiology, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.
Binghua Li *Department of Anesthesiology, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.
Xiaoran WuDepartment of Pediatric Dentistry, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University School of Stomatology, Beijing, 100081, China.
Bin XiaDepartment of Pediatric Dentistry, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University School of Stomatology, Beijing, 100081, China.
Xudong YangDepartment of Anesthesiology, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China. kqyangxudong@163.com.
Tong ChengDepartment of Anesthesiology, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China. chengtong@foxmail.com.

Funding

Clinical Research Foundation of Peking University School and Hospital of Stomatology PKUSS-2023CRF107Program for Health Technologies Promotion of National Center for Stomatology 2024NCSHTP08Young Clinical Research Fund of the Chinese Stomatological Association CSA-A2021-02
6 · The paper itself

Abstract

objectiveTo evaluate the safety and efficacy of intranasal dexmedetomidine combined with propofol for pediatric dental sedation, and identify risk factors associated with major adverse events during deep sedation.

methodsFrom June 2016 to August 2024, children who were unable to cooperate with the short-term oral treatment under non-pharmacological behavior or conscious sedation were selected for inclusion in the study. Intranasal dexmedetomidine 2 µg/kg was administered to facilitate preoperative sedation. Furthermore, a topical anesthetic, lidocaine gel, was applied to the venipuncture site. Once adequate sedation was achieved, venipuncture was performed. If preoperative sedation failed, sevoflurane inhalation was used to facilitate venipuncture. During the oral treatment, continuous target-controlled infusion (TCI) of propofol was administered to maintain a Bispectral index (BIS) of 50-70, ensuring deep sedation. PRIMARY OUTCOMES: Major adverse events (hypoxia, tachycardia, and bradycardia). SECONDARY OUTCOMES: Less severe events (choking cough, gross body movement, and postoperative agitation) and risk factor exploration (interrelationships between tonsillar hypertrophy, surgery duration, and adverse events).

resultsA total of 513 children (359 boys, 69.98%; 154 girls, 30.02%) were enrolled in the study. Oral treatment was successfully completed in 100% of children. Surgery duration significantly influenced the incidence of major adverse events (p < 0.05), with a receiver operating characteristic (ROC) curve identifying 79 min as the optimal cutoff (AUC = 0.653, 95% CI: 0.573-0.733). Tonsillar hypertrophy was associated with a 4.6-fold increased risk of adverse events (OR = 4.61, 95% CI: 1.2-17.8; P = 0.017), driven by higher rates of hypoxemia (33.3% vs. 3.3%, P < 0.001) and choking cough (9.5% vs. 0%, P < 0.001).

conclusionsThis study establishes intranasal dexmedetomidine premedication followed by target-controlled propofol infusion sedation as a safe, effective alternative to general anesthesia for short-duration pediatric dental procedures (< 2 h).

Indexed as

Anesthesia, DentalAnesthetics, IntravenousDeep SedationDental Care for ChildrenDexmedetomidineHypnotics and SedativesPropofolAdministration, IntranasalChildChild, PreschoolFemaleHumansMaleAnesthetics, IntravenousDexmedetomidineHypnotics and SedativesPropofolDeep sedationDexmedetomidinePediatric dental treatmentPropofol

Identifiers

PMID40604736
PMCPMC12224821

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.