Purpose: To evaluate the efficacy of postoperative dexmedetomidine intravenous sedation after bimaxillary orthognathic surgery on postoperative care and hemodynamic parameters.
Patient and methods: Patient admmited for bimaxillary orthognathic surgery ( n = 40) were included. All patients received an patient-controlled analgesia (PCA) using fentanyl citrate for postoperative pain control; then patients in the dexmedetomidine (DEX) group ( n = 21) received dexmedetomidine IV as loading dose (0.4 μg/kg/hr) for 1 day, while patients in non-dexmedetomidine (N-DEX) group ( n = 19) received no another sedatives for postoperative care. After operation, hemodynamic changes [systolic blood pressure, diastolic blood pressure, oxygen saturation and heart rate] were monitored for 1 day in recovery room and ward. Facial swelling score, breathing score, bleeding score and visual analogue scale (VAS) were measured by questionnaire for 3 days postoperatively.
Results: Significant differences were found in the blood pressure and heart rate between DEX group and N-DEX group excluding stable oxygen saturation (Freidman test, P < 0.05). Compared with N-DEX group, DEX group demonstrated lower facial swelling score and lower visual analogue scale at postoperative immediately and day 2 ( t test, P < 0.05). On the other hand, lower breathing score and bleeding score were presented at day 1 and 2 postoperatively ( t test, P < 0.05).
Conclusions: Dexmedetomidine can be proper alternative resource for conscious IV sedative after bimaxillary orthognathic surgery. It has demonstrated hemodynamic and respiratory stability, including patient satisfaction after bimaxillary orthognathic surgery, when used as a sedative agent for postoperative care. Furthemore, there were also no postoperative amnesia suffering patients during sedation.