Injection of Lidocaine Alone versus Lidocaine plus Dexmedetomidine in Impacted Third Molar Extraction Surgery, a Double-Blind Randomized Control Trial for Postoperative Pain Evaluation

Abstract

Objectives. Administration of medications such as dexmedetomidine as a topical anesthetic has been suggested in the pain control in dentistry. This double-blind randomized control trial study evaluated postoperative pain and associated factors following impacted third molar extraction surgery. Lidocaine alone was taken as the control and lidocaine plus dexmedetomidine as the intervention. Materials and Methods. Forty patients undergoing mandibular third molar extraction entered the study and were randomly allocated to the control and interventional groups. 0.15 ml of dexmedetomidine was added to each lidocaine cartridge and the drug concentration was adjusted to 15 μg for the intervention group while only lidocaine was used in the control group. A visual analog scale was used to measure and record pain levels at the end of the surgery and 6, 12, and 24 hours after the surgery and number of painkillers taken by the patients after the surgery was also recorded. Results. Pain scores of the intervention group decreased significantly during the surgery and also 6, 12, and 24 hours after the surgery compared to the control group. The pain score was correlated significantly with our intervention during the surgery and also 6 and 12 hours after that (all P value < 0 . 05 ). There was a nonsignificant reduction in the number of painkillers taken by the patients at 6, 12, and 24 hours after surgery (all P value > 0 . 05 ). Conclusion. In patients undergoing molar surgery, administration of a combination of dexmedetomidine and lidocaine is beneficial for the pain control. Clinical Relevance. Compared to the injection of lidocaine alone, combination of dexmedetomidine and lidocaine can be used for a better pain control in molar surgeries.

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

“…Also, according to Tonooka and colleagues, administration of DEX added to LIDO for dental local anesthesia in eight patients led to improved sedation levels and enhanced pulpal local anesthesia compared to LIDO alone [ 34 ]. Similar results were obtained from other clinical studies by Alizargar, Sing, and colleagues [ 35 , 36 ]. These results are consistent with the outcomes of our study and support the idea that DEX, regardless of the route of administration, could provide superior results concerning the level of sedation and patients' cooperation.…”

Estimating the Need for Sedation in Patients with Dental Anxiety and Medical Complexities Reporting to Tertiary Care Dental Hospital Using the IOSN Tool

“…Many methods for sedation are being used for third molar impactions. All these methods aim to achieve better patient outcomes in terms of pain control as noted in other studies [ 26 ]. Also, patients presenting with periodontal disease with higher anxiety levels, while undergoing scaling and root planning treatments may exhibit negative clinical outcomes.…”

Dexmedetomidine Co-Administered with Lidocaine Decreases Nociceptive Responses and Trigeminal Fos Expression without Motor Dysfunction and Hypotension in a Murine Orofacial Formalin Model

“…Recently, in a randomized controlled trial study, Yamane et al showed that co-administration of dexmedetomidine and lidocaine considerably boosted the local anesthetic strength of lidocaine without any major influences on the cardiovascular system when locally injected into the oral mucosa [56]. Moreover, in dentistry, the co-administration of dexmedetomidine and lidocaine blocked the maxillary and mandibular nerve and significantly prolonged the block duration and shortened the onset of action, as well as the need for fewer analgesics in the postoperative period [59,60].…”