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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Background: Mandibular third molars (M3M) are the most common impacted teeth in the human dentition. Removal or extraction of these teeth is frightening for the patients owing to the perception of pain. As a result, pain control mechanism like anesthesia is the major factor that needs to be executed appropriately. Using newer local anesthetic drugs minimizes side effects and drug interactions. Levobupivacaine (Levo) is a congener of bupivacaine thereby minimizing the cardiotoxic effects of bupivacaine. Dexmedetomidine (Dex) is an alpha agonist which alongwith Levo is capable of providing prolonged duration of anesthesia decreasing the need for rescue analgesics. Aim: This study will compare the anesthetic effectiveness between Levo and Levo alongwith Dex during the extraction of impacted M3M. Methodology: A total of 50 consecutive systemically healthy patients requiring unilateral surgical extraction of impacted M3M with similar orientations will be divided into two groups randomly, one group (L) will receive nerve block with levo while the second group (LD) will receive Levo plus Dex during the extraction procedure. Results: ‘Students t-test’ will be used to analyse and evaluate. The patients will be evaluated based on different parameters. The patient will be asked to reciprocate about the first bout of pain experience based on the Visual Analog Scale that will be handed over to patient after the procedure. The other parameters that will be evaluated are Onset on Anesthesia, Depth of Anesthesia, Hemodynamics, Oxygen saturation level, Sedation level and duration of post-operative analgesia. The patient will be evaluated over the time duration after which the patient had to take a rescue analgesic. Conclusion: Levo with Dex is more efficient than Levo in providing prolonged duration of anesthesia and has prolonged duration of postoperative analgesia.