Psychosedation with dexmedetomidine hydrochloride during minor oral surgery

Abstract

We performed intravenous sedation with dexmedetomidine hydrochloride during minor oral surgery and compared this agent with propofol. Patients were randomly divided into 2 groups: dexmedetomidine hydrochloride (D) and propofol (P) groups. In Group D, systolic blood pressure (SBP) increased immediately after the start of initial loading, although no significant differences were noted. Both SBP and diastolic blood pressure (DBP) gradually decreased during maintenance administration and were significantly lower than pretreatment values. The heart rate decreased immediately after the start of administration and was significantly lower during both initial loading and maintenance administration; the heart rate was also significantly lower than that in Group P. In Group D, arterial blood oxygen saturation (SpO2) significantly decreased after the sedation level reached an optimum level until the end of administration. The bispectral index (BIS) value gradually decreased during initial loading. At the optimal sedation level, it decreased to 80 to 85. During maintenance administration, marked changes were observed in this parameter. No marked differences in amnestic effects and comfort were noted between the 2 groups. If the sedation level can be evaluated accurately via another objective method, intravenous sedation with dexmedetomidine hydrochloride may be useful in dental treatment.

Figures

Figure 1

Changes in blood pressure. In group D, systolic blood pressure (SBP) was significantly higher than that in group P. SBP and diastolic blood pressure (DBP) significantly decreased during maintenance administration compared with pretreatment value in groups D.

Figure 2

Changes in heart rate. In group D, heart rate significantly decreased from 6 minutes after the start of initial loading until the start of maintenance administration. Heart rate in group D was lower than that in group P.

Figure 3

Changes in percutaneous arterial blood oxygen saturation (SpO2). In group D, SpO2 significantly decreased from 6 minutes after the start of administration until the end of maintenance administration. SpO2 in Group D was significantly lower than that in Group P.

Figure 4

Changes in bispectral index (BIS). At the optimum sedation level, BIS was significantly lower than pretreatment values in the 2 groups. During maintenance administration, the fluctuation of BIS in Group D was greater than that in Group P.

Figure 5

Comfortableness of sedation. No significant differences were noted between the 2 groups.