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Effect of adding of dexmedetomidine to local anesthesia in external dacryocystorhinostomy patients

Purpose The aim was to study the efficacy and safety of addition of dexmedetomidine to local anesthesia (LA) for patients undergoing external dacryocystorhinostomy (DCR). Patients and methods A total of 70 adult patients who presented for external DCR were included in this prospective double-blinded study. They were randomly distributed into two equal groups. All patients received LA with 8 ml mixture, composed of 3.5 ml of lidocaine 2% without epinephrine and 3.5 ml of plain bupivacaine 0.5%. Either 1 ml normal saline (0.9%) or that containing 20 µg dexmedetomidine was added to the mixture for each group. The onset and the duration of sensory blockade as well as perioperative sedation were verified. Visual analog score was evaluated in the postoperative period till 12 h postoperatively. Anesthesia-related perioperative complications and patient satisfaction were also reported. Results Dexmedetomidine added to a LA block in external DCR significantly decreased the onset of anesthesia to 2.23±2.11 min (P=0.015) and increased the duration of sensory block to 200.45±37.98 min (P=0.0001). In addition, it significantly decreased the postoperative pain score 6–8 h postoperatively (P<0.05). Moreover, increased sedation level and patient satisfaction were noted (P<0.05), without significant increase in the incidence of adverse effects or complications. Conclusion Addition of low-dose dexmedetomidine to LA infiltration in external DCR hastens the onset and prolongs the effective period of the sensory block. Enhancement of postoperative analgesia, increased perioperative sedation. and improved satisfaction of the patients were achieved without significant complications.