Orthognathic surgery improves dentofacial function and aesthetics, but it’s usually associated with postoperative pain, hemodynamic instability and postoperative nausea/vomiting. Dexmedetomidine, a hypotensive agent, is known for its sedative and analgesic properties in various surgical procedures. This study aims to evaluate its efficacy and safety in orthognathic surgery. We followed PRISMA guidelines throughout the entire process. We searched the following medical databases: PubMed, Embase, Cochrane Library, Web of Science and Scopus. Randomized controlled trials and cohorts on dexmedetomidine in orthognathic surgery were screened and retrieved according to predefined criteria. Primary outcomes include blood loss, anesthesia time, operation time, MAP (mean arterial pressure) and heart rate. R studio software was employed for all analyses indicated. Eight studies, including 1,432 participants, were included in the review, with 7 of them contributing to the analysis. Compared to controls, our meta-analysis revealed that patients on dexmedetomidine showed significantly shorter anesthesia time (MD: -40.75, 95%CI -74.21; -7.29, P = 0.03) and significantly lower heart rate (MD: -12.99, 95%CI -23.23; -2.75, P = 0.03). A non-significant reduction in blood loss (MD: -119.13, 95%CI -333.17; 94.92, P = 0.21) and MAP (MD: -2.47, 95%CI -8.26; 3.31, P = 0.27) was also observed. Our results support the clinical utility of dexmedetomidine in patients undergoing orthognathic surgery. It significantly shortens anesthesia duration and reduces heart rate, with a statistically nonsignificant trend toward reduced intraoperative blood loss.
Molhem et al. (Thu,) studied this question.