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Pediatric Sedation Trial Finds Etomidate and Propofol Regimens Equally Effective

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Posted: July 2, 2026

Pediatric Sedation Trial Finds Etomidate and Propofol Regimens Equally Effective

Edited by Dentaltown staff

Two intravenous sedation regimens were equally safe and effective for dental treatment of uncooperative young children, with the etomidate-based combination offering modest advantages during recovery, according to a randomized clinical trial published online June 29 in Scientific Reports.

The patient- and assessor-blinded crossover trial enrolled 40 children between 3 and 10 years old, all rated negative or very negative on the Frankl behavior scale. Each child was sedated twice in separate sessions, once with etomidate, fentanyl, and midazolam and once with propofol, fentanyl, and midazolam, with the order reversed between groups.

Both combinations kept heart rate and oxygen saturation within safe ranges, and the researchers found no significant hemodynamic difference between them. Mean oxygen saturation stayed above 97% throughout every procedure in both groups.

The etomidate regimen showed greater heart-rate stability and less fluctuation from baseline than the propofol regimen. Children in the etomidate group also recorded higher behavior scores on the Houpt scale during recovery, 7.45 compared with 6.60. Oxygen saturation at the moment of injection was slightly higher with etomidate, a difference the authors called statistically detectable but clinically modest.

Both regimens used fentanyl at 1 microgram per kilogram and midazolam at 0.2 milligram per kilogram, paired with either etomidate at 0.2 milligram per kilogram or propofol at 1 milligram per kilogram.

The authors concluded that both combinations provide comparable, effective sedation and that the etomidate regimen may offer specific benefits in heart-rate stability and recovery behavior for selected pediatric cases. The trial was led by Sedighe Mozafar and colleagues, with senior author Morteza Banakar, and was registered in the Iranian Registry of Clinical Trials.

Sources:
Scientific Reports, “Comparative sedative effects of intravenous etomidate/fentanyl/midazolam versus propofol/fentanyl/midazolam combination for dental treatment of uncooperative children: a randomized clinical trial,” by Sedighe Mozafar et al., published online June 29, 2026 (DOI 10.1038/s41598-026-59790-3): nature.com/articles/s41598-026-59790-3


Pediatric Sedation Trial Finds Etomidate and Propofol Regimens Equally Effective

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