ABSTRACT
INTRODUCTION: Pain control after root canal treatment is of great importance in endodontic practice. The aim of the present study was to investigate the effect of a long-acting anesthetic (bupivacaine) on postoperative pain and the use of analgesics after root canal treatment. METHODS: In a randomized double-blinded clinical trial, 60 patients (30 per group) having first or second mandibular molars with irreversible pulpitis randomly received either 0.5% bupivacaine with 1:200,000 epinephrine or 2% lidocaine with 1:80,000 epinephrine as the anesthetic solutions for inferior alveolar nerve blocks. After single-visit root canal treatment, each patient recorded their pain score on a visual analogue scale at 6, 12, 24, 36, 48, and 72 hours after treatment. Data were analyzed by Mann-Whitney, χ(2), Cochrane Q, and t tests as well as Pearson correlation analysis. RESULTS: The results indicate that patients who received bupivacaine had significantly lower pain scores at 6 and 12 hours after root canal treatment compared with the patients who received lidocaine (P < .05). The use of analgesics in the bupivacaine patients was significantly lower than in the lidocaine group (P < .05). CONCLUSIONS: Patients who received bupivacaine as the anesthetic agent for single-visit endodontic treatment of irreversible pulpitis in mandibular molars had significantly less early postoperative pain and used fewer analgesics than those who had lidocaine as the anesthetic.
