ABSTRACT
A pure s-enantiomer of bupivacaine known as levobupivacaine, is now considered a safer alternative for regional anaesthesia than a racemic solution, bupivacaine since it is as efficacious as bupivacaine, but with better pharmacokinetics. Levobupivacaine is clinically tolerated well in cases requiring regional anaesthesia with both bolus administration and post-operative infusion. There are very few incidence of Adverse Drug Reactions (ADR) if administration is monitored appropriately as most ADRs are due to mistakes causing systemic exposure of drug. Hypersensitivity reaction to drug or pharmacological effects of anaesthesia though rare can also cause ADRs.1 Lidocaine (Xylocaine), is available commonly in a 0.5 % or 1 % solution, though several more concentrations are available. It is the most commonly used infiltrative amide anaesthetic. Higher concentrations show no difference in pharmacodynamics but may increase the risk of toxicity.2 The duration of action may be increased by addition of epinephrine. It can be added in concentrations of 1:100,000 or 1:200,000. This is seen to increase the maximum dose of drug and also reduces blood loss.3 Recent studies have found this combination to be safe to use in nose, ears, fingers and toes. METHODSA randomized comparative study was carried out in a tertiary care teaching hospital, Karad. A total of 112 cases was enrolled in the study who were having chronic suppurative otitis media and who require surgical management by tympanoplasty. Cases with a previous history of ear surgery were excluded. The enrolled cases were classified into group I and group II alternatively and the group I cases were given levobupivacaine 0.5 % and group II were given lidocaine 2 %. Infiltration with local anaesthetic was given in post auricular region. Perioperative analgesics were not given. Post-operative pain was measured by using VAS score and comparison of both groups was done by the Mann Whitney U test. RESULTSLevobupivacaine (8.6 mL) and lidocaine (9.2 mL) used during tympanoplasty in cases were stable throughout the procedure and no post-operative complications were noticed. The mean time of analgesic requirement was 186.43 ± 91.04 minutes and 329.54 ± 135.82 minutes respectively in levobupivacaine group and lidocaine group. The mean quantity of analgesics used was 1.95 ± 1.01 tablets and 3.34 ± 1.10 tablets in the levobupivacaine and lidocaine groups respectively.
ABSTRACT
Introduction: Various approaches are used by pedodontistsacross India and all over world for management of activecarious lesion considering various factors as patient needs.Current study aimed to evaluate current trends towardsmanagement options of active carious lesions among PediatricDentists across India.Material and methods: Web based cross sectional surveywas done. A thirteen point questionnaire was prepared andsent via email to pediatric dentists registered in Indian Societyof Pediatric and preventive Dentistry across India. Data wasanalysed using descriptive statistics and chi square test withsignificance level p<0.05.Results: A total of 212 pediatric dentists responded out of 1150sent e-mail and results from their responses concluded thatmajority of the pedodontists (83.96%) are using noninvasivecaries management techniques in private practice, 14.1%responded that they don’t use and 1.88% pedodontists didn’tresponded. Most of the respondents (61.79%) use Silverdiamine fluoride (SDF) in their clinical practice where as35.84% pedodontists not using SDF in their practice.Conclusion: Within limitation of the study, it can be concludedthat Current trends towards management of active cariouslesion among pediatric dentists is shifting towards minimalinvasive dentistry where current material of choice amongthem is Silver diamine fluoride. Although more studies areencouraged to enhance knowledge and awareness about SDFuse in future.