In IV sedation used for dental surgery, neither fentanyl or nalbuphine more effective as an analgesic

UTHSCSA Dental School CAT Library, 2012

In IV sedation used for dental surgery, neither fentanyl or nalbuphine more effective as an analgesic.
In a patient undergoing IV moderate conscious sedation associated with dental surgery, is fentanyl or nalbuphine more effective as a peri-operative analgesic?
Neither fentanyl or nalbuphine is shown to have a clinical advantage as a peri-operative analgesic associated with IV moderate sedation in the dental office.
#1) Dolan 1998 50 patients, ASA 1 or 2 RCT Key results Dental surgery patients who required IV sedation, were given equipotent doses of either fentanyl or nalbuphine along with diazepam.
There was no significant difference in pain relief, sedation, recall, and peri-operative vital signs.
#2) Lefevre 1992 24 patients, ASA 3 or 4 RCT Key results ASA 3 and 4 patients who required IV sedation for dental surgery were given equipotent doses of either fentanyl or nalbuphine.
This effect should be considered when treating medically compromised patients, and may indicate the use of nalbuphine over fentanyl.
Although there are higher levels of evidence published comparing these opioid analgesics in anesthesia, these two articles represent the best evidence using these medications associated with dental surgery and administered in a dental setting for IV moderate conscious sedation.
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