Investigating the efficacy of dexmedetomidine as an adjuvant to local anesthesia in dentistry: systematic review and meta-analysis
Abstract
Background: Dexmedetomidine (DEX) has been considered an effective adjunct to dental local anesthetics. Uncertainty about its efficacy and safety in dental use still remains.
Objectives: This study is primarily designed to evaluate the effectiveness and safety of DEX as an adjunct to local anesthesia in dental procedures.
Methods: This study followed PRISMA guidelines. The protocol was registered in PROSPERO (CRD420251035026). Outcomes were onset time, anesthesia duration, postoperative analgesia duration, post operative pain, sedation, and adverse events. Searches covered PubMed, Cochrane Library, Ovid, Embase, Web of Science, and Google Scholar. Risk of bias was assessed with Cochrane RoB 2 and ROBINS-I. RevMan 5.1 pooled mean differences and assessed heterogeneity. Sensitivity analyses and publication bias were examined in Comprehensive Meta-Analysis v3.7. Certainty of evidence was rated with GRADE.
Results: This meta-analysis encompassed sixteen controlled clinical trials comprising 658 participants. The addition of DEX decreased onset time by 48.78 s (95% CI: 64.22 to 33.35 s, p 2 = 94% and 99%, respectively). Hemodynamic evaluation revealed no clinically significant alterations in heart rate, intraoperative systolic and diastolic pressure, and oxygen saturation (p > 0.05 for all parameters). Minor variations in heart rate and blood pressure did not advance to hypotension or bradycardia.
Conclusions: Dexmedetomidine as an adjunct to dental local anesthesia may reduce…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 658 participants or records.
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