Enhanced Analgesic Outcomes with Low-dose Dexmedetomidine and Lignocaine-Adrenaline in Pediatric Inferior Alveolar Nerve Block: A Randomized Trial.

AIM AND BACKGROUND: The present double-blind randomized trial was conducted to evaluate if dexmedetomidine enhances the effect of lignocaine-induced local anesthesia in 4-8-year-old children undergoing mandibular molar pulpectomies. MATERIALS AND METHODS: This double-blind randomized controlled trial included 60 pediatric patients scheduled for mandibular molar pulpectomy, who were allocated into 2 groups. In group A (n = 30), inferior alveolar nerve block was administered with 2% lignocaine containing adrenaline (1:2,00,000), whereas group B (n = 30) received the same solution supplemented with a low dose of dexmedetomidine (0.5 µg/kg). The primary variable assessed was intraoperative pain, evaluated through the Wong-Baker Faces Pain Rating Scale and the FLACC (Face, Legs, Activity, Cry, and Consolability) scale. Secondary variables comprised commencement and persistence of anesthesia, sedation levels, and vital signs. Data analysis was performed using independent t-tests, with statistical significance set at p < 0.05. RESULTS: Children administered the dexmedetomidine-lignocaine combination demonstrated lower pain scores than those who received lignocaine alone, as shown by the Wong-Baker scale (p = 0.009) and the FLACC scale (p = 0.025). Furthermore, the onset of anesthesia occurred in a shorter duration, and the effect persisted longer with the dexmedetomidine-lignocaine combination (p = 0.001). No sedative effects were observed, and all physiological parameters remained stable in both groups of participants. CONCLUSION: The low-dose dexmedetomidine successfully enhanced the effect of lignocaine by providing faster and enhanced anesthesia for better pain control. CLINICAL SIGNIFICANCE: Incorporating low-dose dexmedetomidine with lignocaine in pediatric pulpectomies enhances local anesthetic efficacy by reducing pain, shortening onset, and prolonging duration of anesthesia. This combination offers a safer and more comfortable treatment experience for young children.