Efficacy and Safety of Clonidine versus Placebo for Anxiety in Odontology
Introduction: There are different strategies for anxiety control in dentistry. The objective of this study was to determine the efficacy and safety of clonidine medication versus placebo to decrease anxiety and pain in third-molar extraction.
Methods: a placebo controlled clinical trial, randomized, triple-blind, parallel group design, included 40 healthy patients aged 14 to 40, who would be undergoing third molar surgery, with a score ≥ 13, in accordance with the Modified Dental Anxiety Scale (mdas); there were 20 patients per group who received 150 mcg clonidine and a control group that received the placebo. The groups were randomized in balanced blocks, and the masking consisted of uniform tableting. Primary outcome: change in anxiety according to mdas; secondary outcome: vital signs, change in the pain scale and side effects.
Results: decreased anxiety in both groups, with no significant differences between the clonidine group compared with placebo (p = 0.704); in the experimental group average pressure decreased when compared with the placebo (p = 0.033).
Conclusion: clonidine is safe, and even though when compared to the placebo showed no significant anxiety reduction, in the clonidine group a decrease in average arterial pressure was observed, which could reflect reduced anxiety, considering its somatic signs.
How to Cite
License
Every single author of the articles has to declare that is an original unpublished work exclusively created by them, that it has not been submitted for simultaneous evaluation by another publication and that there is no impediment of any kind for concession of the rights provided for in the contract.
In this sense, the authors committed to await the result of the evaluation by the journal Revista Nacional de Odontologia before considering its submission to another medium; in case the response by that publication is positive, additionally, the authors committed to respond for any action involving claims, plagiarism or any other kind of claim that could be made by third parties.
At the same time, the authors have to declare that they are completely in agreement with the conditions presented in their work and that they cede all patrimonial rights. These rights involve reproduction, public communication, distribution, dissemination, transformation, making it available and all forms of exploitation of the work using any medium or procedure, during the term of the legal protection of the work and in every country in the world, to the Universidad Cooperativa de Colombia Press.
Ng SKS, Leung WK. A community study on the relationship of dental anxiety with oral health status and oral health-related quality of life. Community Dent Oral Epidemiol. 2008; 36(4): 347-56.
Caycedo C, Cortés OF, Gama R, Rodríguez H, Colorado P, Caycedo M et al. Ansiedad al tratamiento odontológico: Características y diferencias de género. Suma Psicológica. 2008; 15(1): 259-78.
Kvale G, Berggren U, Milgrom P. Dental fear in adults: a meta-analysis of behavioral interventions. Community Dent Oral Epidemiol. 2004; 32(4): 250-64.
Lahmann C, Schoen R, Henningsen P, Ronel J, Muehlbacher M, Loew T et al. Brief relaxation versus music distraction in the treatment of dental anxiety: a randomized controlled clinical trial. J Am Dent Assoc. 2008; 139(3): 317-24.
Kritsidima M, Newton T, Asimakopoulou K. The effects of lavender scent on dental patient anxiety levels: a cluster randomized-controlled trial. Community Dent Oral Epidemiol. 2010; 38(1): 83-7.
Lee-Kim SJ, Fadavi S, Punwani I, Koerber A. Nasal versus oral midazolam sedation for pediatric dental patients. J Dent Child (Chic). 2004; 71(2): 126-30.
Carreño ML, Benavente C, Acosta O, Sendín MB. Sedación y anestesia general en el paciente odontopediátrico. Gaceta dental: Ind Prof. 2008; 192: 88-111.
Lago-Méndez L, Diniz-Freitas M, Senra-Rivera C, Seoane-Pesqueira G, Gándara-Rey JM, García-García A. Postoperative recovery after removal of a lower third molar: role of trait and dental anxiety. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108(6): 855-60.
Gordon D, Heimberg RG, Tellez-Merchán M, Ismail A. A Critical review of approaches to the treatment of dental anxiety in adults. J Anxiety Disord. 2013; 27(4): 365-78.
Sandín B, Chorot P, Santed MA, Jiménez P, Romero M. Ansiedad cognitiva y somática: relación con otras variables de ansiedad y psicosomáticas. Rev Psicol Gen Apl. 2002; 47(3): 313-20.
Cao J, Shi X, Miao X, Xu J. Effects of premedication of midazolam or clonidine on perioperative anxiety and pain in children. Biosci Trends. 2009; 3(3): 115-8.
Hall DL, Rezvan E, Tatakis DN, Walters JD. Oral clonidine pretreatment prior to venous cannulation. Anesth Prog. 2006; 53(2): 34-42.
Jacob R. Entendiendo la anestesia pediátrica. 2a Ed. [libro electrónico]. Portal Médico Moderno. 2012 [Consultado: 2 de junio del 2013]. Disponible en: http:// medicomoderno.org/entendiendo-la-anestesia-pediatrica- 2a-ed-rebecca-jacob/
Imai Y, Mammoto T, Murakami K, Kita T, Sakai T, Kagawa K et al. The effects of preanesthetic oral clonidine on total requirement of propofol for general anesthesia. J Clin Anesth. 1998; 10(8): 660-5.
Chowdhury S, Singh M, Shah A. Efficacy of lignocaine with clonidine and adrenaline in minor oral surgical procedure. Contemp Clin Dent. 2012; 3(2): 227-9.
Hall DL, Tatakis DN, Walters JD, Rezvan E. Oral clonidine pre-treatment and diazepam/meperidine sedation. J Dent Res. 2006; 85(9): 854-8.
Trevor S, Upadya M, Sinha C, Kaur M. A comparison of midazolam and clonidine as an oral premedication in pediatric patients. Saudi J Anaesth. 2012; 6(1): 8-11.
Lizawa A, Oshima T, Kasuya Y, Dohi S. Oral tandospirone and clonidine provide similar relief of preoperative anxiety. Can J Anaesth. 2004; 51(7): 668-71.
Van Die MD, Bone KM, Burger HG, Teede HJ. Are we drawing the right conclusions from randomised placebo- controlled trials? A post-hoc analysis of data from a randomized controlled trial. bmc Med Res Method. 2009; 9(1): 41.
