Does dexmedetomidine combined with levobupivacaine in inferior alveolar nerve blocks among patients undergoing impacted third molar surgery control postoperative morbidity?

Comparative Analysis of Anaesthetic Efficacy of 2% Lignocaine With Dexmedetomidine as an Adjunct in Nerve Blocks for Dental Extractions: A Randomised Controlled Study

Introduction

Adequate perioperative pain control through peripheral nerve blocks is a time-honored practice. Local anesthetic (LA) alone may fail to provide desirable pain control operatively. Dexmedetomidine (DEXMED), is a relatively latest addition to the class of α agonists. The present study was deliberated with the hypothesis that addition of DEXMED to LA does not alter the potency and efficacy of lignocaine. The primary outcome variable measured was pain. Onset, depth of anesthesia, and vital parameters duration of postoperative analgesia following administration of nerve blocks with the two solutions were also measured.

Method

A prospective, randomized, crossover, double-blind study was conducted on 60 systemically healthy subjects for extraction of premolars in all four quadrants. Subjects were randomly assigned to receive lignocaine mixed with epinephrine (2% lignocaine in 1:2,00,000 epinephrine) or lignocaine plus DEXMED (1μcg/ml lignocaine). On the second appointment of the study, the subjects received the other solution. Pulse rate, blood pressure, arterial oxygen saturation (SPo2), and respiratory rate were recorded as a baseline before performing, during, and two hours later.

Results

It showed the comparison of onset of anesthesia, and duration of anesthesia in between the two groups was found to be significant (p=0.00) in Group D and Group L. Number of subjects who consumed analgesics in Group L was 34 and in Group D was 14. The hemodynamic parameters displayed no statistically significant difference from their baseline values in the two groups.

Conclusion

The study concluded that dexmedetomidine when administered with lignocaine in nerve blocks provides greater hemodynamic stability and increases its anesthetic and analgesic potency making it a suitable addition to the existing list of additives for local anesthetic agents.