A Public Health Perspective on Sedation Dentistry in Bangladesh: Use of Clonidine

Abstract

Background: Since more than 40 years ago, people have been using the alpha-2 adrenergic agonist clonidine to treat hypertension. The FDA authorized the use of clonidine in October 2008 as a premedication drug before sedation. This study's main objective is to discover if clonidine may be used as a pre-operative sedative in mild sedation dentistry and, if so, at what dosage level is safe to do so. Methods: A large inner city dental clinic that offers free dental treatment to those in need participated in this clinical, cross-sectional research of its patients. Information was gathered from treatment records completed between March 2012 and April 2012. Examined were the relationships between the research sample's characteristics and the usage of clonidine at two dosage levels (0.1 mg and 0.2 mg compared to controls). The hemodynamic changes (such as systolic, diastolic, mean arterial pressure, and pulse) in patients receiving clonidine 0.1 mg, clonidine 0.2 mg, and the control group were compared using an analysis of variance with the Duncan Multiple Range Test. Results: Pre-sedation systolic and diastolic blood pressure readings were lower in the clonidine 0.2 mg group compared to the 0.1 mg group and the control group. According to the findings, the control group's mean systolic blood pressure was considerably higher during the first intraoperative period than the 0.2 group's. Mean systolic blood pressures for the 0.2 mg clonidine dose group were substantially lower at pre-sedation and the first intraoperative periods in comparison to the 0.1 mg group and the controls after adjusting for age, BMI, and Versed dosage. After model correction, there was no discernible difference in the three groups' diastolic blood pressures. Conclusion: The use of clonidine did not significantly reduce the quantity of sedatives required, according to this study's findings. When compared to the 0.1 mg group and the controls in the adjusted model, the mean systolic blood pressures for the 0.2 mg clonidine dose group were significantly lower at the pre-sedation and the first intraoperative times; however, there were no significant differences across the measurement times for the effect of clonidine on diastolic blood pressure.