ABSTRACT
Background: Ropivacaine has been successfully used in surgery, gynaecology and obstetrics, but is not currently available for dentists. Reports support the use of Ropivacaine as a long acting local anaesthetic in oral and maxillofacial surgical procedures requiring surgical anaesthesia and post-operative analgesia. Aim: The aim of the study was to compare the anaesthetic efficacy of 0.75% Ropivacaine with that of 2% Lidocaine Hydrochloride during the surgical removal of impacted mandibular third molars. Material and Methods: A prospective randomized double-blind clinical trial was conducted on 28 subjects who required surgical extracted of one or both of their impacted mandibular third molars. A single operator performed the extractions following injection of either 0.75% Ropivacaine or 2% Lidocaine Hydrochloride + 1: 80,000 conc. adrenaline, randomly in a double-blind manner. Pain during the surgery was assessed using a Visual Analog Scale. Other parameters that were considered, included the time of onset of anaesthesia, duration of anaesthesia and the need for re-anaesthesia during the procedure. Results: The results showed that differences in time of onset for 0.75% Ropivacaine (92.27 ± 34.85 secs) and 2% lidocaine (79.14 ± 11.065 secs), duration of action for 0.75% Ropivacaine (5.03 ± 0.41 hrs) and 2% Lidocaine (3.27 ± 056 hrs) and intraoperative pain for 0.75% Ropivacaine (1.27) and 2% Lidocaine (0.00) were statistically significant. Also, 2% of subjects required a re-anaesthesia using 0.75% Ropivacaine whereas none of the subjects which were given 2% Lidocaine, required reanaesthesia. Conclusion: The study concludes that the clinical effects of 2% Lidocaine with 1: 80,000 conc. Adrenaline in terms of latency, intraoperative pain control and depth of anaesthesia are superior to 0.75% Ropivacaine, though the latter gives a prolonged duration of anaesthesia.
KEYWORDS:Lidocaine , Ropivacaine, Impacted Molars INTRODUCTION