Does Including Dexmedetomidine Improve Outcomes After Intravenous Sedation for Outpatient Dentoalveolar Surgery?

Effects of dexmedetomidine in non-operating room anesthesia in adults: a systematic review with meta-analysis

“…Most of the studies did not report any statistically significant difference in patient satisfaction between the groups studied (n = 28; 58.3%). 61 , 78 , 41 , 23 , 25 , 81 , 36 , 38 , 96 , 43 , 56 , 35 , 73 , 53 , 58 , 92 , 74 , 29 , 39 , 85 , 75 , 26 , 37 , 60 , 47 , 93 , 79 , 94 However, 33.3% (n = 16) reported a statistically significant higher patient satisfaction with DEX, when compared with the control group, 28 , 65 , 30 , 71 , 89 , 109 , 98 , 44 , 52 , 22 , 54 , 57 , 18 , 34 , 97 , 70 and 8.3% (n = 4) studies reported a statistically significant higher patient satisfaction in favor of the control group. 69 , 104 , 46 , 45 …”

“… Taniyama 33 Japan NR 21.4 14 1 Minor oral surgery BP, HR, SpO 2 , Mackenzie's sedation assessment score and BIS 1: 6 mg.kg −1 .h −1 iv DEX hydrochloride for 10 min + 0.4 μg.kg −1 .h −1 infusion DEX hydrochloride 2: 20 mg iv lidocaine hydrochloride + 0.5 mg.kg −1 bolus propofol + 4 mg.kg −1 .h −1 infusion propofol Before and during the procedure No clear definition Amnesia, comfort, sedation score and hemodynamic and respiratory effects. Taylor 34 USA (32–74) 42 12 1, 2 Maxillary and mandibular arch extractions with associated dentoalveolar pre-prosthetic surgery NIBP, ECG, pulse oximetry, capnography, RR 1: 4 mg.kg −1 .h −1 infusion DEX + 2 mg iv MDZ + 50 mg iv fentanyl 2: 2 mg iv MDZ + 50 mg iv fentanyl + infusion normal saline Before and during the procedure, until 15 min to the end of the procedure Anesthesia times, vital signs and the patient subjective experience NR Togawa 35 Japan (20–80) 93.2 88 1, 2 Minor oral surgery NIBP, ECG, HR, SpO 2 and BIS 1: 0.02 mg.kg −1 MDZ + 3 μg.kg −1 .h −1 infusion DEX for 10 min + 0.2–0.7 μg.kg −1 .h −1 infusion DEX 2: 0.02 mg.kg −1 MDZ + 1.0 μg.mL −1 target plasma concentration propofol (up titrated until desired sedation level) Before and during the procedure Unexpected patient movement Responsiveness, mouth opening time, cough, snoring, total and rescue dose of MDZ, patient and physician satisfaction, amnesia, recovery profile, hemodynamic and respiratory effects, operating time and sedation time. Wang 36 China NR 61.7 60 1,2 Dental implant surgery NIBP, ECG, pulse oximeter and OAA/S score 1: 1.0 μg.kg −1 DEX for 10 min + 0.2–0.7 μg.kg −1 .…”

“…In total, 48 studies evaluated patient satisfaction as an outcome. The scales used were very different and included, for example, VAS score 10 cm, 61 , 89 , 69 , 54 , 35 , 57 , 58 , 29 , 75 , 26 a questionnaire, 109 , 74 , 34 , 45 a 7-point Likert scale 30 , 56 , 97 , 70 , 60 or a satisfaction score (4 = excellent, 3 = good, 2 = fair, and 1 = bad), 65 , 71 , 46 , 47 , 94 among others. Candiotti et al.…”

The Choice of Anesthetic Drugs in Outpatient Hysteroscopic Surgery: A Systematic Review and Network Meta-Analysis

“…Moreover, dexmedetomidine is characterized by good intraoperative arousal [ 9 ]. Dexmedetomidine, propofol, and remimazolam tosylate were all common anesthetic drugs in outpatient hysteroscopic surgery [ 10 , 11 ]; however, the efficacy of the three drugs in outpatient hysteroscopic procedures is marginally studied.…”