Comparison of Dexmedetomidine and Ketamine for Managing Postoperative Symptoms After Third-Molar Surgery.

Purpose: Lower-impacted third-molar surgery is the most common oral-maxillofacial surgery procedure and involves a considerable degree of soft- and bony-tissue trauma. This study measured and compared postoperative sequalae between patients receiving dexmedetomidine or ketamine after third-molar surgery.

Patients And Methods: This study was a randomized double-blind prospective trial. The patients were divided into 2 groups: ketamine and dexmedetomidine. Pain, swelling, and trismus outcomes were evaluated before and 2 and 7 days after surgery. In addition, patients were asked to record the number and timing of oral analgesic tablets they required during the postoperative period. Data were analyzed using the Mann-Whitney U test and a repeated-measures general linear model. The significance level was set at P < .05.

Results: The study included 66 patients (38 women and 28 men) undergoing extraction of impacted mandibular third molars. Significant differences were found between the groups in visual analog scale pain scores at 1, 6, and 12 hours after surgery (P < .001, P = .010, and P = .030, respectively). Trismus and swelling did not differ significantly between the 2 groups (P > .05).

Conclusions: Ketamine resulted in less postoperative pain than dexmedetomidine during the first 12 hours after third-molar surgery.