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: Brajković Denis, Biočanin Vladimir, Milić Marija, Vučetić Milan, Petrović Renata, Brković Božidar
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2015-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501501050B.pdf
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author Brajković Denis
Biočanin Vladimir
Milić Marija
Vučetić Milan
Petrović Renata
Brković Božidar
author_facet Brajković Denis
Biočanin Vladimir
Milić Marija
Vučetić Milan
Petrović Renata
Brković Božidar
author_sort Brajković Denis
collection DOAJ
description 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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spelling doaj-art-751306ef2a5f48de82c6055a75d0f4d52025-08-20T03:19:14ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502015-01-01721505610.2298/VSP1501050B0042-84501501050BQuality of analgesia after lower third molar surgery: A randomised, double-blind study of levobupivacaine, bupivacaine and lidocaine with epinephrineBrajković Denis0Biočanin Vladimir1Milić Marija2Vučetić Milan3Petrović Renata4Brković Božidar5Faculty of Medicine, Department of Maxillofacial Surgery, KragujevacFaculty of Medicine, Department of Oral Surgery, KragujevacFaculty of Dental Medicine, Clinic of Oral Surgery, BelgradeFaculty of Dental Medicine, Clinic of Oral Surgery, BelgradeFaculty of Dental Medicine, Department of Restorative Dentistry and Endodontics, BelgradeFaculty of Dental Medicine, Clinic of Oral Surgery, BelgradeBackground/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]http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501501050B.pdftooth extractionmolar, thirdbupivacainelidocaineanesthesia, dentalpain, postoperativequestionaires
spellingShingle Brajković Denis
Biočanin Vladimir
Milić Marija
Vučetić Milan
Petrović Renata
Brković Božidar
Quality of analgesia after lower third molar surgery: A randomised, double-blind study of levobupivacaine, bupivacaine and lidocaine with epinephrine
Vojnosanitetski Pregled
tooth extraction
molar, third
bupivacaine
lidocaine
anesthesia, dental
pain, postoperative
questionaires
title Quality of analgesia after lower third molar surgery: A randomised, double-blind study of levobupivacaine, bupivacaine and lidocaine with epinephrine
title_full Quality of analgesia after lower third molar surgery: A randomised, double-blind study of levobupivacaine, bupivacaine and lidocaine with epinephrine
title_fullStr Quality of analgesia after lower third molar surgery: A randomised, double-blind study of levobupivacaine, bupivacaine and lidocaine with epinephrine
title_full_unstemmed Quality of analgesia after lower third molar surgery: A randomised, double-blind study of levobupivacaine, bupivacaine and lidocaine with epinephrine
title_short Quality of analgesia after lower third molar surgery: A randomised, double-blind study of levobupivacaine, bupivacaine and lidocaine with epinephrine
title_sort quality of analgesia after lower third molar surgery a randomised double blind study of levobupivacaine bupivacaine and lidocaine with epinephrine
topic tooth extraction
molar, third
bupivacaine
lidocaine
anesthesia, dental
pain, postoperative
questionaires
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501501050B.pdf
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