The Addition of Dexmedetomidine Offers a Safer Option for Pain Control

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Published in Anesthesia Progress, a new study suggests that the addition of dexmedetomidine proves a safer option for dental related pain control without the adverse cardiovascular effects of other local anesthetics.

Anesthesia Progress volume 67 issue 2

Anesthesia Progress volume 67 issue 2

New research suggests that the addition of dexmedetomidine proves a safer option for pain control without the adverse cardiovascular effects of other local anesthetics.

Anesthesia Progress—Safe and painless procedures are the cornerstone of modern dentistry. As more people are paying attention to their oral healthcare and appearance, there is a high demand for safe, pain-free procedures. Patient safety and comfort is a top priority for dental anesthesiologists, and new research suggests that the addition of dexmedetomidine proves a safer option for pain control without the adverse cardiovascular effects of other local anesthetics.

Researchers from the Nippon Dental University School of Life Dentistry in Tokyo, Japan, published a study in the current issue of Anesthesia Progress that compared the use of the traditional oral pain block, a mixture of articaine and epinephrine, with a mixture of articaine and low-dose dexmedetomidine (DEX). Both epinephrine and DEX would prolong the “numbing” effects of the articaine; however, epinephrine can exhibit adverse effects, whereas low-dose DEX would provide a low-toxicity option without the risk cardiovascular complications.

The researchers used a rat model to examine the duration of a pain block using (1) normal saline (NS), (2) articaine alone (A), (3) articaine in combination with epinephrine (EA), or (4) articaine in combination with DEX (DA). Forty-four rats were evenly distributed into four groups and were exposed to high heat on one of their paws. After 5 minutes, their paw was injected with one of the pain blocks, and their pain level was assessed at 5-minute intervals to test the duration of effectiveness from 0 to 40 minutes.

The researchers found no significant change in the duration of the NS solution. The rats did have an increase in effective duration when given the A, EA, and DA solutions. The A solution alone had an overall lasting effect of approximately 20 minutes, whereas the EA and DA solutions lasted up to 40 minutes. This shows that with the addition of DEX, the effectiveness of the articaine pain block is similar in duration to that of the traditional articaine plus epinephrine solution. This finding is extremely important because the addition of low-dose DEX has no effect on blood pressure or heart rate, which are adverse effects seen when using epinephrine.

The researchers in this study have identified the combination of DEX and articaine to be a potentially safer combination for a pain-blocking solution than the traditional articaine and epinephrine. They suggest further investigations to determine the effectiveness at longer time intervals as well as testing the sedative effects of DEX.
Full text of the article, “Adding Dexmedetomidine to Articaine Increases the Latency of Thermal Antinociception in Rats,” Anesthesia Progress, Vol. 67, No. 2, 2020, is now available here: https://meridian.allenpress.com/anesthesia-progress/article/67/2/72/439961/Adding-Dexmedetomidine-to-Articaine-Increases-the

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About Anesthesia Progress
Anesthesia Progress is the official publication of the American Dental Society of Anesthesiology (ADSA). The quarterly journal is dedicated to providing a better understanding of the advances being made in the science of pain and anxiety control in dentistry. The journal invites submissions of review articles, reports on clinical techniques, case reports, and conference summaries. To learn more about the ADSA, visit: http://www.adsahome.org/.

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Dominique Scanlan
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