Non-Cochrane · intervention · PM42073135
The Efficacy of Dexmedetomidine Versus Ketamine for Sedation in Pediatric Dental Procedures: A Systematic Review and Meta-Analysis.
Alasmri AbdulRahman, Alhijab Ali, Abudawood Shahad N, et al. · Children (Basel, Switzerland) · 2026 · PubMed · doi:10.3390/children13040558
Findings
Population Children aged 2-14 years undergoing dental procedures (sedation or premedication before general anesthesia)
7 findings
| Dexmedetomidine (any route) | Ketamine (any route) | Intraoperative analgesia (FLACC score) Intraoperative · Pediatric dental sedation or premedication before general anesthesia | MD 0.26 [-0.23, 0.75] Low Downgraded: risk of bias, imprecision, indirectness 2 studies · 98 participants |
| Dexmedetomidine (any route) | Ketamine (any route) | Systolic blood pressure (mmHg) Pediatric dental sedation or premedication before general anesthesia | MD -6.69 [-6.91, -6.47] Low Downgraded: risk of bias, imprecision, indirectness 2 studies · 98 participants |
| Dexmedetomidine (any route) | Ketamine (any route) | Oxygen saturation (SpO2, %) Pediatric dental sedation or premedication before general anesthesia | MD 0.08 [-0.56, 0.72] Low Downgraded: risk of bias, imprecision, indirectness 2 studies · 98 participants |
| Dexmedetomidine (any route) | Ketamine (any route) | Heart rate (beats/min) Pediatric dental sedation or premedication before general anesthesia | MD -11.7 [-29.27, 5.86] Low Downgraded: risk of bias, imprecision, indirectness 2 studies · 98 participants |
| Dexmedetomidine (any route) | Ketamine (any route) | Postoperative analgesia (FLACC score) Postoperative · Pediatric dental sedation or premedication before general anesthesia | MD 0.23 [-0.12, 0.58] Low Downgraded: risk of bias, imprecision, indirectness 2 studies · 98 participants |
| Dexmedetomidine (any route) | Ketamine (any route) | Recovery time (min) Pediatric dental sedation or premedication before general anesthesia | MD 5.99 [-6.21, 18.18] Low Downgraded: risk of bias, imprecision, inconsistency, indirectness 4 studies · 178 participants |
| Dexmedetomidine (any route) | Ketamine (any route) | Diastolic blood pressure (mmHg) Pediatric dental sedation or premedication before general anesthesia | MD -1.93 [-6.02, 2.17] Low Downgraded: risk of bias, imprecision, indirectness 2 studies · 98 participants |
Included primary studies 5
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Surendar 2014 A comparative evaluation of intranasal dexmedetomidine, midazolam and ketamine for their sedative and analgesic properties: a triple blind… PMID:25095322 | 2014 | 1 other review | not stated | not extracted yet |
| Hammadyeh 2019 Comparison of two intravenous sedation techniques for use in pediatric dentistry: A randomized controlled trial. PMID:31596061 | 2019 | this review only | not stated | not extracted yet |
| Singh 2014 A comparative evaluation of analgo-sedative effects of oral dexmedetomidine and ketamine: a triple-blind, randomized study. PMID:25065424 | 2014 | this review only | not stated | not extracted yet |
| Surendar 2014 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Zanaty 2015 A comparative evaluation of nebulized dexmedetomidine, nebulized ketamine, and their combination as premedication for outpatient pediatric… PMID:25822924 | 2015 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Intranasal dexmedetomidine versus midazolam for pediatric dental sedation: a pooled analysis of clinical trials. (2026) | 1 | 0.05 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children aged 2-14 years undergoing dental procedures (procedural sedation or premedication before GA) | Children undergoing dental procedures, mean age 6.5-9.1 years (n=178) |
| Intervention | Dexmedetomidine (any route) for sedation or premedication | Dexmedetomidine: intranasal, nebulized, intravenous, oral; 1-5 ug/kg (n=89) |
| Comparison | Ketamine (any route) for sedation or premedication | Ketamine: intranasal, nebulized, intravenous, oral; 2-8 mg/kg (n=89) |
| Outcomes | Intraoperative and postoperative analgesia, heart rate, SBP, DBP, SpO2, recovery time | Intraoperative FLACC (n=98); postoperative FLACC (n=98); heart rate (n=98); SBP (n=98); DBP (n=98); SpO2 (n=98); recovery time (n=178) |
| Study designs | RCTs | RCTs (n=4) |
| Timing | Not specified | Not specified |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |