A comparison between dexmedetomidine hydrochloride and propofol in sedation following oral and maxillofacial surgery

We studied 30 patients sedated with dexmedetomidine hydrochloride or propofol under tracheal intubation following oral and maxillofacial surgery at the dental operating room in Okayama University Hospital between November 2005 and August 2006. We compared the effects on amnesia and relief of postoperative discomfort between dexmedetomidine hydrochloride and propofol, analyzing questionnaires completed a week after surgery. Sedation was given to the patients at the sedation levels around a Ramsay Score of 3 or 4. The patients were divided into the dexmedetomidine hydrochloride group (D group : 19 patients) and the propofol group (P group : 11 patients). We evaluated 3 points : 1) recall during tracheal intubation, 2) recall at extubation, and 3) postoperative discomfort. Statistical analysis was performed, using the Mann-Whitney test. Furthermore, the relationship between amnesia and relief of postoperative discomfort was analyzed in both groups, using a chi-square test. Results : the rate of recall during tracheal intubation in the P group was significantly less than that in the D group (p = 0.025), and the rate of recall at extubation in P group was also significantly less than that in D group (p = 0.047). According to postoperative discomfort, the rate of "very uncomfortable" or "uncomfortable feeling" in the P group was significantly lower than that in the D group (p = 0.003). There was a significant correlation between amnesia and relief of discomfort, and the patients with amnesia were relieved of postoperative discomfort. In conclusion, the present study indicated that compared to propofol, sedation with dexmedetomidine hydrochloride has poor effects on amnesia and relief of postoperative discomfort under tracheal intubation following oral and maxillofacial surgery. Furthermore, the results suggest that amnesia is an important factor for sedation to relieve postoperative uncomfortable feeling under tracheal intubation for oral and maxillofacial surgery.