BACKGROUND AND OBJECTIVE Securing the airway in the surgery of maxillofacial disorders and traumas is fundamental during the operation. The present study aims to investigate the beneficial sedative effects of dexmedetomidine (DEX) in patients who underwent maxillofacial surgery with regional anesthesia compared to general anesthesia. METHODS Fifty patients, aged 20-45 years old were randomly divided into two groups of regional anesthesia (RA) and general anesthesia (GA) (each n=25). The group RA received regional block with sedation (DEX: 1 μg/kg infused over 10 min followed by the maintenance dose of 0.5 μg/kg/h) and the group GA underwent general anesthesia (DEX: 0.1 μg/kg/min over 10 min followed by 0.4-0.7 μg/kg/h). Postoperative pain scores, anesthesia outcomes, hemodynamic parameters, the time of the post-anesthesia care unit (PACU) discharge and intra and postoperative complications were comparatively assessed in both groups. RESULTS The baseline characteristics of the patients (age, gender, BMI, and ASA physical status) showed no differences between the two groups (P>0.05). Although the duration of surgery and recovery time showed no differences between the groups, the duration of anesthesia and extubation time was remarkably lower in the RA group than in the GA group (P<0.01). Administration of nerve blocks demonstrated less pain and longer sleep time in the postoperative phase as compared to the GA group. Heart rate and mean arterial blood pressure were significantly less in the RA group at the end of the loading dose of DEX and incision time (P<0.05). SpO2, respiration rate and Ramsay sedation scale did not exhibit any significant differences between the two groups at all-time points (P>0.05). No significant differences were observed with regard to the adverse events between the two groups (P>0.05). CONCLUSIONS Although our findings revealed that both methods are suitable and safe methods for maxillofacial surgery, the outcomes of anesthesia with regional block and sedation include less pain in the postoperative phase, shorter extubation time and earlier discharge from the PACU demonstrated that this method is more reliable for maxillofacial surgery. Further controlled studies are needed to compare the effectiveness and safety profiles of two RA and GA techniques and also to compare DEX with other anesthetic agents to achieve optimum outcomes in maxillofacial surgeries.

中文翻译：

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右美托咪定全身麻醉与区域麻醉对颌面手术患者镇静效果的比较研究。

背景与目的在颌面部疾病和创伤手术中，确保气道安全是手术过程中的基础。本研究旨在探讨右美托咪定 (DEX) 对接受区域麻醉的颌面手术患者与全身麻醉相比的有益镇静作用。方法50例患者，年龄20～45岁，随机分为区域麻醉（RA）组和全身麻醉（GA）组，每组25例。RA 组接受局部镇静阻滞（DEX：1 μg/kg 输注超过 10 分钟，然后维持剂量为 0.5 μg/kg/h），GA 组接受全身麻醉（DEX：0.1 μg/kg/min 超过 10 分钟）分钟后跟 0.4-0.7 微克/千克/小时）。术后疼痛评分、麻醉结果、血流动力学参数、比较两组患者麻醉后监护病房（PACU）出院时间及术中术后并发症发生情况。结果 两组患者的基线特征（年龄、性别、BMI、ASA体力状况）无差异（P>0.05）。虽然手术持续时间和苏醒时间组间无差异，但RA组麻醉持续时间和拔管时间明显短于GA组（P<0.01）。与 GA 组相比，神经阻滞的给药在术后阶段表现出更少的疼痛和更长的睡眠时间。DEX负荷剂量结束和切开时间结束时，RA组心率和平均动脉压明显降低（P<0.05）。血氧饱和度，呼吸率和 Ramsay 镇静量表在所有时间点上两组之间没有任何显着差异（P > 0.05）。两组不良事件发生率无显着差异（P>0.05）。结论 虽然我们的研究结果表明这两种方法都是适用于颌面外科手术的安全方法，但局部阻滞和镇静麻醉的结果包括术后疼痛减轻、拔管时间更短和从 PACU 提前出院证明这种方法更可靠用于颌面手术。需要进一步的对照研究来比较两种 RA 和 GA 技术的有效性和安全性，并将 DEX 与其他麻醉剂进行比较，以实现颌面手术的最佳结果。