Does dexmedetomidine combined with levobupivacaine in inferior alveolar nerve blocks among patients undergoing impacted third molar surgery control postoperative morbidity?
Patil Shweta Murlidhar, Jadhav Anendd, Bhola Nitin, Hingnikar Pawan, Kshirsagar Krutarth, Patil Dipali,
소속 상세정보
( Patil Shweta Murlidhar ) - Datta Meghe Institute of Medical Sciences Sharad Pawar Dental College and Hospital Department of Oral and Maxillofacial Surgery
( Jadhav Anendd ) - Datta Meghe Institute of Medical Sciences Sharad Pawar Dental College and Hospital Department of Oral and Maxillofacial Surgery
( Bhola Nitin ) - Datta Meghe Institute of Medical Sciences Sharad Pawar Dental College and Hospital Department of Oral and Maxillofacial Surgery
( Hingnikar Pawan ) - Datta Meghe Institute of Medical Sciences Sharad Pawar Dental College and Hospital Department of Oral and Maxillofacial Surgery
( Kshirsagar Krutarth ) - Datta Meghe Institute of Medical Sciences Sharad Pawar Dental College and Hospital Department of Oral and Maxillofacial Surgery
( Patil Dipali ) - Grant Government Medical College
Abstract
Background: Postoperative analgesia (POA) is an important determinant of successful treatment. Dexmedetomidine (DEX) has recently gained attention as a promising adjuvant to local anesthetics (LA). The present study aimed to evaluate the efficacy and safety of levobupivacaine (LB) as an adjuvant during inferior alveolar nerve block (IANB) in the extraction of lower impacted third molars (LITM).
Methods: A prospective, randomized, placebo-controlled, triple-blind, parallel-arm, and clinical study was performed on 50 systemically healthy participants who required removal of an asymptomatic LITM. Using a 1:1 distribution, the participants were randomized into two groups (n = 25). Group L (control group) received 1.8 mL of 0.5% LB and 0.2 mL normal saline (placebo) and Group D (study group) received a blend of 1.8 mL of 0.5% LB and 0.2 mL (20 μg) DEX. The primary outcome variable was the duration of POA and hemodynamic stability, and the secondary variable was the total number of analgesics required postoperatively for up to 72 h. The participants were requested to record the time of rescue analgesic use and the total number of rescue analgesics taken. The area under the curve was plotted for the total number of analgesics administered. The pain was evaluated using the visual analog scale. Data analysis was performed using paired students and unpaired t-test, Mann?Whitney U test, Chi-square test, and receiver operating characteristic analysis. Statistical significance was set at P < 0.05.
Results: The latency, profoundness of anesthesia, and duration of POA were statistically significant (P < 0.05). The differences between mean pain scores at 6, 12, 24, 48, and 72 h were found to be significant (each P = 0.0001). Fewer analgesics were required by participants in group D (2.12 ± 0.33) than in L (4.04 ± 0.67), with a significant difference (P = 0.0001).
Conclusion: Perineurally administered LA with DEX is a safe, effective, and therapeutic approach for improving latency, providing profound POA, and reducing the need for postoperative analgesia.
키워드
Analgesia; Dexmedetomidine; Impacted Mandibular Third Molars; Inferior Alveolar Nerve Block; Levobupivacaine; Local Anesthesia
원문 및 링크아웃 정보
등재저널 정보