Comparison of Three Intravenous Sedation Techniques Used for Extracting Mandibular Third Molars in Dental Patients

This study compared the effects of three intravenous sedation techniques used during mandibular third molar extraction in dental patients to find a suitable method with high safety and comfort. Patients undergoing third molar extraction at Yantai Stomatology Hospital of Binzhou Medical University and Yantai Zhifu Hospital Dental Clinic from November 2021 to December 2022 were enrolled and randomly assigned to three groups: group A received propofol and esketamine (n=50), group B received propofol and dexmedetomidine (n=50), and group C received propofol (n=50; control). The primary monitoring indicators included vital signs, blood gas analysis, bispectral index (BIS) score, and adverse reactions at T0 (admission), T1 (start of surgery), T2 (10 min after start of surgery), and T3 (end of surgery). The secondary monitoring indicators included recovery time, patient satisfaction, and doctor satisfaction. Among the three groups of patients, MAP and HR of group A were higher than group B and group C, while group C had higher MAP and HR than group B. The indicators of respiratory function SPO2, PaO2 and PaCO2 of group B were worse than those of group A and group C, and the BIS value of group B was also lower, but patient satisfaction and doctor satisfaction were the highest. Patients in group C had shorter wake time, followed by group B. Group A woke up the slowest. Group A had higher incidence of hypertension, sychnosphygmia, hallucination, restlessness, and dizziness than group B, but lower incidence of hypertension, sychnosphygmia, hallucination, and dizziness than group C. Groups A and C had lower bradyarrhythmia incidence . Thus, the three sedation techniques are effective during mandibular third molar extraction and are safe for use in surgical sedation. Regarding comfort and treatment satisfaction, dexmedetomidine and propofol combination is more suitable for mandibular third molar extraction.