Efficacy of bupivacaine [with adrenaline 1: 200,000 for postoperative pain relief after the surgical removal of impacted third molars: a comparison with lidocaine with adrenaline 1: 80,000]

ABSTRACT

In a randomized, single-blind controlled study we compared the efficacy of 0.25% Bupivacaine [with adrenaline 1200,000] [0.25% Marcaine, Cooke-Waite Labs] with 2% Lidocaine [with adrenaline 180,000] [2% Xylocaine, Astra] for postoperative pain relief in 53 patients having day care surgery under general anaesthesia for the removal of impacted mandibular third molars. PATIENTS AND METHODS: Patients were randomly allocated to receive 3 ml of 2% Lidocaine with 180,000 adrenaline on one side and 3 ml of 0.25% Bupivacaine with 1200,000 adrenaline on the opposing side. The patient's pain response was recorded at every 10min interval till 80 minutes, visual analog pain score was taken for every interval. The time at which the patient requested first dose of post-operative analgesia was recorded and whether it was for the right side, left side or both sides was also noted. In total, 6 [11.3%] of patients demonstrated lidocaine as more effective, 34 [64.2%] of patients demonstrated Bupivacaine as more effective and 13 [24.5%] of patients were not able to demonstrate any difference in effectiveness between the two local anaesthetic agents. The study also showed that patients given Bupivacaine had lower average visual analogue pain scores [VAS]. The side of the jaw given Bupivacaine reported complete pain relief for a much longer period of time when compared to lidocaine. Bupivacaine seems to be a suitable alternative local anaesthetic and analgesic to lidocaine [with adrenaline] for post operative pain control