A Comparative Study Evaluating the Efficacy of Lignocaine and Dexmedetomidine with Lignocaine and Adrenaline in Third Molar Surgery

The aim of this study was to compare the anesthetic efficacy, duration of action, pain, and cardiovascular effects of dexmedetomidine when added to 2% lignocaine hydrochloride in bilateral symmetrical impacted third molars.

This study comprised of 40 healthy patients who required extraction of identical bilateral impacted lower third molars. The left side of the patients was designated as test side where patients received local anesthesia with lignocaine plus dexmedetomidine (2% lignocaine + dexmedetomidine 1 μ/ml), and the right side of the patients was designated as control side where patients received local anesthesia with lignocaine plus adrenaline (2% lignocaine in 1:80,000 adrenaline). Both surgical interventions were performed at two different appointments with a minimum time interval of 2 weeks. The time to onset and duration of action were noted as primary outcome variables, while the secondary outcome variables included pain and hemodynamic changes associated with dexmedetomidine if any.

Onset of action of the local anesthesia was found to be faster in addition to having a relatively longer duration of action when the newer drug dexmedetomidine was added to lignocaine when compared with the conventional combination of lignocaine and adrenaline (P < 0.05). There were no significant changes in the systolic blood pressure, diastolic blood pressure, and heart rate from the baseline following the injection of dexmedetomidine.

The study demonstrated that the combination of dexmedetomidine with lignocaine enhances the local anesthetic potency of lignocaine without significant systemic effects when locally injected into oral mucosa.