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Clinical Oral Investigations

Erschienen in:

22.08.2023 | Research

Analgesic effect of a lidocaine-ropivacaine mixture for extraction of impacted mandibular third molars: a randomized controlled trial

verfasst von: Tomoharu Hemmi, Nobuyuki Sasahara, Kazuyuki Yusa, Shigeo Ishikawa, Takehito Kobayashi, Mitsuyoshi Iino

Erschienen in: Clinical Oral Investigations | Ausgabe 10/2023

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Abstract

Objectives

The painless postoperative period can be significantly prolonged by using long-acting local anesthetics such as ropivacaine, though these local anesthetics are known for their slower onset of action. To compensate for this, a mixture of short-onset (e.g., lidocaine) and long-acting local anesthetics is used. However, the efficacy of such an anesthetic cocktail has not been elucidated in the field of oral and maxillofacial surgery.

Materials and methods

To address the research purpose, this prospective randomized controlled trial included 56 patients scheduled for impacted mandibular third molar extraction. All patients received the inferior alveolar nerve block (IANB) using either 2% lidocaine with epinephrine or a 1:1 mixture of 2% lidocaine with epinephrine and 0.75% ropivacaine.

Results

Patients anesthetized using the lidocaine-ropivacaine mixture showed significantly prolonged postoperative analgesia and pain control than those anesthetized using lidocaine only.

Conclusions

IANB using a lidocaine-ropivacaine mixture can provide prolonged postoperative anesthesia and pain control with extraction of mandibular third molars.

Clinical relevance

This method can be a noteworthy addition to existing methods of local anesthesia for the extraction of mandibular third molars.

Trial registration number University Hospital Medical Information Network (No. UMIN000044315)

Lopes V, Mumenya R, Feinmann C, Harris M (1995) Third molar surgery: an audit of the indications for surgery, post-operative complaints and patient satisfaction. Br J Oral Maxillofac Surg 33:33–35. https://doi.org/10.1016/0266-4356(95)90083-7CrossRefPubMed

McGrath C, Comfort MB, Lo EC, Luo Y (2003) Changes in life quality following third molar surgery—the immediate postoperative period. Br Dent J 194:265–268. https://doi.org/10.1038/sj.bdj.4809930. (discussion 1)CrossRefPubMed

Camps-Font O, Figueiredo R, Sanchez-Torres A et al (2020) Which is the most suitable local anaesthetic when inferior nerve blocks are used for impacted mandibular third molar extraction? A network meta-analysis. Int J Oral Maxillofac Surg 49:1497–1507. https://doi.org/10.1016/j.ijom.2020.04.016CrossRefPubMed

Ernberg M, Kopp S (2002) Ropivacaine for dental anesthesia: a dose-finding study. J Oral Maxillofac Surg 60:1004–1010. https://doi.org/10.1053/joms.2002.34409. (discussion 10-11)CrossRefPubMed

Reddy KV, Jadhav A, Bhola N, Mishra A, Dakshinkar P (2019) Is 0.75% ropivacaine more efficacious than 2% lignocaine with 1:80,000 epinephrine for IANB in surgical extraction of impacted lower third molar? Oral Maxillofac Surg 23:225–231. https://doi.org/10.1007/s10006-019-00779-wCrossRefPubMed

Budharapu A, Sinha R, Uppada UK, Subramanya Kumar AV (2015) Ropivacaine: a new local anaesthetic agent in maxillofacial surgery. Br J Oral Maxillofac Surg 53:451–454. https://doi.org/10.1016/j.bjoms.2015.02.021CrossRefPubMed

Yang F, Gao Y, Zhang L et al (2020) Local anaesthesia for surgical extraction of mandibular third molars: a systematic review and network meta-analysis. Clin Oral Investig 24:3781–3800. https://doi.org/10.1007/s00784-020-03490-3CrossRefPubMed

Cuvillon P, Nouvellon E, Ripart J et al (2009) A comparison of the pharmacodynamics and pharmacokinetics of bupivacaine, ropivacaine (with epinephrine) and their equal volume mixtures with lidocaine used for femoral and sciatic nerve blocks: a double-blind randomized study. Anesth Analg 108:641–649. https://doi.org/10.1213/ane.0b013e31819237f8CrossRefPubMed

Gadsden J, Hadzic A, Gandhi K et al (2011) The effect of mixing 1.5% mepivacaine and 0.5% bupivacaine on duration of analgesia and latency of block onset in ultrasound-guided interscalene block. Anesth Analg 112:471–476. https://doi.org/10.1213/ANE.0b013e318265ba9aCrossRefPubMed

10.

World Medical Association (2013) WMA Declaretion of Helsinki: ethical principles for medical research involving human subjects. Adopted by the 18^th WMA General Assembly, Helsinki, Finland, June 1964, and amended by the: 29^th WMA General Assembly, Tokyo, Japan, October 1975 35^th WMA General Assembly, Venice, Italy, October 1983 41^st WMA General Assembly, Hong Kong, September 1989 48^th WMA General Assembly, Somerset West, Republic of South Africa, October 1996 52^nd WMA General Assembly, Edinburgh, Scotland, October 2000 53^th WMA General Assembly, Washington 2002 (Note of Clarification on paragraph 29 added) 55^th WMA General Assembly, Tokyo 2004 (Note of Clarification on Paragraph 30 added) 59^th WMA General Assembly, Seoul, October 2008 64^th WMA General Assembly, Fortaleza, Brazil, October 2013. Accessed 18 Jun 2023.

11.

Takasugi Y, Furuya H, Moriya K, Okamoto Y (2000) Clinical evaluation of inferior alveolar nerve block by injection into the pterygomandibular space anterior to the mandibular foramen. Anesth Prog 47:125–129PubMedPubMedCentral

12.

Amorim KS, Gercina AC, Ramiro FMS et al (2021) Can local anesthesia with ropivacaine provide postoperative analgesia in extraction of impacted mandibular third molars? A randomized clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol 131:512–518. https://doi.org/10.1016/j.oooo.2020.09.010CrossRef

13.

Ozer S, Yaltirik M, Kirli I, Yargic I (2012) A comparative evaluation of pain and anxiety levels in 2 different anesthesia techniques: locoregional anesthesia using conventional syringe versus intraosseous anesthesia using a computer-controlled system (Quicksleeper). Oral Surg Oral Med Oral Pathol Oral Radiol 114:S132–S139. https://doi.org/10.1016/j.oooo.2011.09.021CrossRefPubMed

14.

Jain NK, John RR (2016) Anesthetic efficacy of 4% articaine versus 2% lignocaine during the surgical removal of the third molar: a comparative prospective study. Anesth Essays Res 10:356–361. https://doi.org/10.4103/0259-1162.171445CrossRefPubMedPubMedCentral

15.

Barath S, Triveni VS, Sai Sujai GV, Harikishan G (2015) Efficacy of 2% mepivacaine and 2% lignocaine in the surgical extraction of mesioangular angulated bilaterally impacted third molars: a double-blind, randomized, clinical trial. J Pharm Bioallied Sci 7:S600–S606. https://doi.org/10.4103/0975-7406.163564CrossRefPubMedPubMedCentral

16.

Brkovic B, Andric M, Calasan D et al (2017) Efficacy and safety of 1% ropivacaine for postoperative analgesia after lower third molar surgery: a prospective, randomized, double-blinded clinical study. Clin Oral Investig 21:779–785. https://doi.org/10.1007/s00784-016-1831-2CrossRefPubMed

17.

Danielsson K, Evers H, Holmlund A, Kjellman O, Nordenram A, Persson NE (1986) Long-acting local anaesthetics in oral surgery. Clinical evaluation of bupivacaine and etidocaine for mandibular nerve block. Int J Oral Maxillofac Surg 15:119–126. https://doi.org/10.1016/s0300-9785(86)80131-4CrossRefPubMed

18.

Chaki T, Sugino S, Janicki PK et al (2016) Efficacy and safety of a lidocaine and ropivacaine mixture for scalp nerve block and local infiltration anesthesia in patients undergoing awake craniotomy. J Neurosurg Anesthesiol 28:1–5. https://doi.org/10.1097/ANA.0000000000000149CrossRefPubMed

19.

Bobik P, Kosel J, Świrydo P, Tałałaj M, Czaban I, Radziwon W (2020) Comparison of the pharmacological properties of 0.375% bupivacaine with epinephrine, 0.5% ropivacaine and a mixture of bupivacaine with epinephrine and lignocaine—a randomized prospective study. J Plast Surg Hand Surg 54:156–160. https://doi.org/10.1080/2000656X.2020.1720999CrossRefPubMed

20.

Moolagani VR, Burla SR, Neethipudi BR, Upadhyayula SM, Bikkina A, Arepalli NR (2019) Ropivacaine plus lidocaine versus bupivacaine plus lidocaine for peribulbar block in cataract surgery: a prospective, randomized, double-blind, single-center, comparative clinical study. J Anaesthesiol Clin Pharmacol 35:498–503. https://doi.org/10.4103/joacp.JOACP_341_18CrossRefPubMedPubMedCentral

21.

McLure HA, Rubin AP (2005) Review of local anaesthetic agents. Minerva Anestesiol 71:59–74PubMed

22.

Tsukimoto S, Takasugi Y, Aoki R, Kimura M, Konishi T (2019) Inferior alveolar nerve block using the anterior technique to anesthetize buccal nerve and improve anesthesia success rates for third molar extraction: a randomized controlled trial and magnetic resonance imaging evaluation. J Oral Maxillofac Surg 77:2004–2016. https://doi.org/10.1016/j.joms.2019.04.021CrossRefPubMed

Titel: Analgesic effect of a lidocaine-ropivacaine mixture for extraction of impacted mandibular third molars: a randomized controlled trial
verfasst von: Tomoharu Hemmi
Nobuyuki Sasahara
Kazuyuki Yusa
Shigeo Ishikawa
Takehito Kobayashi
Mitsuyoshi Iino
Publikationsdatum: 22.08.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 10/2023
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-023-05210-z

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Analgesic effect of a lidocaine-ropivacaine mixture for extraction of impacted mandibular third molars: a randomized controlled trial

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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