Quality of analgesia after lower third molar surgery: A randomised, double-blind study of levobupivacaine, bupivacaine and lidocaine with epinephrine
Background/Aim. Surgical extraction of lower third molars is followed by mild or severe postoperative pain which peaks at maximal intensity in the first 12 hours and has a significant impact on a patient’s postoperative quality of life. The use of long-acting local anaesthetics is a promisi...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2015-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501501050B.pdf |
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| Summary: | Background/Aim. Surgical extraction of lower third molars is followed by mild
or severe postoperative pain which peaks at maximal intensity in the first 12
hours and has a significant impact on a patient’s postoperative quality of
life. The use of long-acting local anaesthetics is a promising strategy to
improve postoperative analgesia. The aim of the present study was to
investigate analgesic parameters and patient satisfaction after using 0.5%
levobupivacaine (Lbup), 0.5% bupivacaine (Bup) and 2% lidocaine with
epinephrine 1:80,000 (Lid + Epi) for an inferior alveolar nerve block
following lower third molar surgery. Methods. A total of 102 patients (ASA I)
were divided into three groups, each of which received either 3 mL of Lbup,
Bup or Lid + Epi. The intensity of postoperative analgesia was measured using
a verbal rating scale (VRS). The total amounts of rescue analgesics were
recorded on the first and during seven postoperative days. Patients
satisfaction was noted using a modified verbal scales. Results. A
significantly higher level of postoperative pain was recorded in Lid + Epi
group compared to Bup and Lbup groups. No significant differences were seen
between Bup and Lbup, but a significant reduction in the need for rescue
analgesics was seen postoperatively in both Lbup and Bup (50%) in comparison
with Lid + Epi (80%) in the first 24 hours. The same significant trend in
rescue analgesic consumption was recorded for seven postoperative days.
Patients’ overall satisfaction was significantly lower for Lid + Epi (10%)
than for Lbup (56%) and Bup (52%). Conclusion. The use of a new and
long-acting local anaesthetic 0.5% levobupivacaine is clinically relevant and
effective for an inferior alveolar nerve block and postoperative pain control
after third molar surgery. In our study Lbup and Bup controled postoperative
pain more efficiently after lower third molar surgery compared to Lid + Epi.
[Projekat Ministarstva nauke Republike Srbije, br. 175021] |
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| ISSN: | 0042-8450 |