Evaluation of Analgesic Efficacy of Dexmedetomidine as an Adjuvant to Local Anaesthesia in Maxillofacial Soft Tissue Injuries: A Prospective Randomised Clinical Trial.

Aims and objectives: Dexmedetomidine is a relatively new, potent, and highly selective α2-adrenergic receptor agonist used for perioperative sympatholytic, analgesia, and sedation. We conducted this study to evaluate the effects of dexmedetomidine as an adjunct to local anaesthesia for maxillofacial soft tissue injuries as day care in the emergency department on patient hemodynamics and analgesic efficacy.

Materials and methods: Eighty patients gave informed consent to participate in the study. They were divided into Groups P and D, each of which consisted of 40 participants. Patients received saline injections in Group P, and Group D received dexmedetomidine (DEX) with local anaesthesia infiltration to both groups. Hemodynamic parameters, duration of surgery, pain of first rescue analgesia, Pain score, patient satisfaction, and surgeons satisfaction were recorded and quantified using unpaired t tests or Mann-Whitney and ANOVA tests. Data and qualitative data parameters were compared using Chi-square test. A P value < 0.05 was considered significant.

Results: Our study showed statistically significant reduced heart rate, systolic, and diastolic blood pressures in DEX compared to the placebo group where none had hypotension or bradycardia in clinical settings. The dexmedetomidine group had shorter operative time and decreased need for analgesia due to lower VAS scores. Patient and surgeon satisfaction were superior in the DEX group compared to the other groups.

Conclusion: Dexmedetomidine effectively suppresses the hemodynamic stress response during minor surgical procedures. We conclude that dexmedetomidine is an effective medication to be used in the emergency room for day-care procedures, as a potent analgesic, anxiolytic providing hemodynamically stable patients, with minimal side effects. We summarise that considering the above properties of dexmedetomidine can be incorporated into ERAS (early return after surgery) protocol, making it an optimal drug of choice as an alternative to moderate sedative drugs, in managing soft tissue injuries of maxillofacial region.