Risks and benefits of pre-operative dexmedetomidine in oral and maxillofacial surgeries: a systematic review

ABSTRACT

Introduction: Oral and maxillofacial surgeries might induce anxiety and pain to the patients. Sedative agents are one of the best ways for eliminating such consequences. Dexmedetomidine (DEX) is a recent sedative agent which presents higher sedative quality with greater specificity than other drugs. The aim of present paper is to evaluate the risks and benefits of administrating DEX during oral and maxillofacial surgeries by reviewing high quality released articles.

Areas covered: Searches on PubMed, Scopus and Web of Science databases were completed with focus on randomized controlled trials (RCT). Related articles, from 2000 to 2015, were selected based on inclusion criteria and quality assessments factors. Full texts of the selected articles were screened and their significant information were gathered for judgments.

Expert opinion: 17 RCTs on a total of 765 patients were screened. Some of the difficulties during reviewing the articles were: different pharmacokinetic and pharmacodynamics of drugs when combined with DEX, different time spots and method of monitoring, including studies on both minor and major surgeries for better data collection. Recent researches are going to focus on application of DEX for in-office procedures because of its desirable properties. Nevertheless, the analgesic and amnesic features of DEX are still questionable.

KEYWORDS:

• Dexmedetomidine
• oral surgery procedure
• sedation
• third molar

Article highlights

• DEX is one of the best choice for in-office dental surgeries.

• DEX provides a paramount sedative quality with easy arousability

• It provides less adverse effect on psychomotor system

• Decreased HR and sBP of DEX might not be dangerous however conventional monitoring methods are recommended to avoid any possible consequences, specially during in-office procedures.

• The analgesic and amnesic features of DEX are still in doubts.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.