Abstract
The aim of the study was to determine whether or not dexmedetomidine- (DEX-) based intravenous infusion in dental implantation can provide better sedation and postoperative analgesia via suppressing postoperative inflammation and oxidative stress. Sixty patients were randomly assigned to receive either DEX (group D) or midazolam (group M). Recorded variables were vital sign (SBP/HR/RPP/SpO2/RR), visual analogue scale (VAS) pain scores, and observer's assessment of alertness/sedation scale (OAAS) scores. The plasma levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), antioxidant superoxide dismutase (SOD), and the lipid peroxidation product malondialdehyde (MDA) were detected at baseline and after 2, 4, and 24 h of drug administration. The VAS pain scores and OAAS scores were significantly lower for patients in group D compared to group M. The plasma levels of TNF-α, IL-6, and MDA were significantly lower in group D patients than those in group M at 2 h and 4 h. In group M, SOD levels decreased as compared to group D at 2 h and 4 h. The plasma levels of TNF-α, IL-6, and MDA were positively correlated with VAS pain scores while SOD negatively correlated with VAS pain scores. Therefore, DEX appears to provide better sedation during office-based artificial tooth implantation. DEX offers better postoperative analgesia via anti-inflammatory and antioxidation pathway.
Highlights
Dental implants are considered one of the most common and popular treatment options for edentulous patients in modern dentistry
Our previous study indicated that the DEX/fentanyl regimen appears to be better than the traditional midazolam/fentanyl regimen in terms of intraoperative arousal, patient-surgeon cooperation, postoperative analgesia, and surgeon satisfaction in office-based unilateral impacted tooth extraction [14]
There was no significant difference in demographic data, surgical characteristics, duration of operation, and total volume of local anaesthetic used between the two study groups
Summary
Dental implants are considered one of the most common and popular treatment options for edentulous patients in modern dentistry. Implant surgery requires bone preparation, sometimes flap and bone graft treatment. This usually results in tissue ischemia [3] and acute inflammation [4, 5] with concomitant increase in oxidative stress. More and more dental patients choose general anaesthesia for comfortable and painless surgery. In these cases, the most widely used form is the combination of benzodiazepine with opioid [12, 13]. The effects and detailed mechanisms of postoperative analgesia effect of DEX in patients undergoing dental implantation surgery have yet to be revealed
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