Comparison of Dexmedetomidine and Ketamine for Managing Postoperative Symptoms After Third-Molar Surgery

Gürsoytrak, Burcu; Kocatürk, Özlem; Koparal, Mahmut; Gülsün, Belgin

doi:10.1016/j.joms.2020.10.020

Cited by 7 publications

(6 citation statements)

References 14 publications

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“…Regarding pain evaluation, Gursoytrak et al showed that submucosal administration of DEX added to articaine local anesthesia could be considered an effective tool for controlling postoperative symptoms including edema, trismus, and pain [ 29 ]. However, when comparing DEX to ketamine in another study with a similar design, it was demonstrated that ketamine was superior to DEX concerning postoperative pain control [ 31 ]. The outcome of our study supports the results of their first trial and the efficacy of DEX in postoperative pain control.…”

Section: Discussionmentioning

confidence: 99%

“…At the end of the surgery, patients were asked whether they were relaxed or anxious during the operation using a short dental fear questionnaire (SDFQ) as a 4-point Likert scale that shows the greater numerical value for greater fear ( Figure 1 ) [ 29 ]. Patients' cooperation was assessed by a cooperation scale consisting of three parts ( Table 2 ) [ 30 ], and their overall satisfaction was evaluated by a linear, nongraded 10 cm VAS assessed by a blind observer at the end of the procedure [ 31 ]. VAS scores of satisfaction of both patient and surgeon were recorded between 0 (not satisfied at all) to 10 (very satisfied) [ 32 ].…”

Section: Methodsmentioning

confidence: 99%

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Effect of Dexmedetomidine Added to Lidocaine Cartridge on the Level of Patient Sedation, Cooperation, and Patient and Surgeon Satisfaction during Mandibular Third-Molar Extraction Surgery: A Randomized Double-Blind Controlled Trial

Kaviani

Salimian

et al. 2022

International Journal of Dentistry

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Background. Various methods have been introduced for anxiety control during third-molar extraction surgery. Dexmedetomidine (DEX) is known to have analgesic, anxiolytic, and sympatholytic properties with minimal adverse effects. This study aimed to evaluate the impact of the local injection of the combination of DEX and Lidocaine on patients’ anxiety and the surgeon’s satisfaction during third-molar extraction surgery. Methods. A total number of 26 healthy volunteers with symmetrical bilateral impacted mandibular third-molar teeth indicated for surgical removal were included in this double-blind randomized controlled trial. A single experienced surgeon performed two surgical extraction procedures within at least four-week time intervals using anesthetic cartridges containing “DEX + LIDO” or “LIDO alone” used randomly on each side for each patient. The Visual Analog Scale and the SDFQ index were used to evaluate patients’ anxiety and surgeon satisfaction during the procedure. Results. SDFQ reports showed that patients in the “DEX” group were 1.5 times more relaxed than those in the “LIDO alone” group. As a result, the level of sedation was considered statistically significant between the two groups (Wilcoxon test, P value <0.019). Wilcoxon test results also showed significant differences between the two groups regarding patients’ overall cooperation in terms of interfering movement and verbal presentation of discomfort ( P value <0.05); however, this difference was not considered significant regarding nonverbal signs of discomfort ( P value >0.05). Moreover, both the surgeon and the patients reported a significantly higher satisfaction rate in the DEX group (paired T-test, df = 25, P value <0.05). Conclusions. It was inferred from the outcomes of the present study that the application of DEX added to the LIDO local anesthesia cartridge could significantly benefit anxious patients with previous unpleasant dental treatment experiences. Trial Registration. This trial is registered with the clinical trial registration number: IRCT20200406046966N.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Effect of Dexmedetomidine Added to Lidocaine Cartridge on the Level of Patient Sedation, Cooperation, and Patient and Surgeon Satisfaction during Mandibular Third-Molar Extraction Surgery: A Randomized Double-Blind Controlled Trial

Kaviani

Salimian

et al. 2022

International Journal of Dentistry

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“…Several studies used mouth opening to assess the efficacy of anti-inflammatory drugs. Balakrishnan et al [ 40 ], Paiva-Oliveira et al [ 41 ] Momesso et al [ 42 ] and Gursoytraket al [ 43 ] find an important reduction in mouth opening on immediately postoperative period. However, there is less limitation of mouth opening in groups that used corticosteroid, especially in the first 24 hours after surgery [ 41 , 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…Balakrishnan et al [ 40 ], Paiva-Oliveira et al [ 41 ] Momesso et al [ 42 ] and Gursoytraket al [ 43 ] find an important reduction in mouth opening on immediately postoperative period. However, there is less limitation of mouth opening in groups that used corticosteroid, especially in the first 24 hours after surgery [ 41 , 42 , 43 ]. The reduction of mouth opening resolves within 7–10 days after surgical procedure with ad-ministration of antibiotics and analgesics [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

A Novel Technique to Accurately Measure Mouth Opening Using 3D Electromagnetic Articulography

et al. 2022

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The mouth opening is an important indication of the functionality of the temporomandibular joint (TMJ). Mouth opening is usually evaluated by asking the patient to open their mouth as wide as possible and measuring the distance between the edges of the frontal incisors with a ruler or caliper. With the advancement of technology, new techniques have been proposed to record mandibular movement. The aim of this work is to present a novel technique based on 3D electromagnetic articulography and data postprocessing to analyze the mouth opening considering distances, trajectories, and angles. A maxilla-mandible phantom was used to simulate the mouth opening movement and fixed position mouth opening. This was recorded using the AG501 3D EMA (Carstens Medizinelektronik GmbH, Bovenden, Germany). The collected data was processed using Matlab (Mathworks, Natick, MA, USA). Fix and mobile mouth opening of 1, 2, 3 and 4 cm were simulated. It was possible to evaluate the mandibular opening through the vertical distance, the Euclidean distance, the trajectory, and the opening angle. All these values were calculated and the results were consistent with expectations. The trajectory was the highest value obtained while the vertical distance was the lowest. The angle increased as the mouth opening increased. This new technique opens up new possibilities in future research since oral opening can be analyzed using multiple variables without the need to use different devices or depending on the researcher’s experience. This will make it possible to establish which parameter presents significant differences between groups of patients or between patients who have undergone some treatment.

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“…DEX demonstrates analgesic properties via selective α2 adrenergic receptor agonist activity and anti-inflammatory and anti-oxidative pathways [ 4 ]. Its systemic analgesic effect has been validated by numerous studies as it has emerged as a preferred analgesic for pain control in acute postoperative settings [ 5 6 ]. Recently, DEX as an adjunct to LA has evoked special interest in locoregional pain control [ 7 8 ].…”

Section: Introductionmentioning

confidence: 99%

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

Patil

Jadhav

Bhola

et al. 2022

J Dent Anesth Pain Med

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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.

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Comparison of Dexmedetomidine and Ketamine for Managing Postoperative Symptoms After Third-Molar Surgery

Cited by 7 publications

References 14 publications

Effect of Dexmedetomidine Added to Lidocaine Cartridge on the Level of Patient Sedation, Cooperation, and Patient and Surgeon Satisfaction during Mandibular Third-Molar Extraction Surgery: A Randomized Double-Blind Controlled Trial

Effect of Dexmedetomidine Added to Lidocaine Cartridge on the Level of Patient Sedation, Cooperation, and Patient and Surgeon Satisfaction during Mandibular Third-Molar Extraction Surgery: A Randomized Double-Blind Controlled Trial

A Novel Technique to Accurately Measure Mouth Opening Using 3D Electromagnetic Articulography

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

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