The Efficacy of Two Different Concentrations of Local Anaesthetic on Pain in Mandibular Third Molar Surgery
10.21315/aos2020.15.2.455
- Author:
Thippayarat Piernon
1
Author Information
1. Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, 6 Yothi Street, Rachathewee District, Bangkok 10400, Thailand
- Collective Name:Basel Mahardawi; Kumar KC; Chakorn Vorakulpipat; Bishwa Prakash Bhattarai; Natthamet Wongsirichatb
- Publication Type:Journal Article
- Keywords:
Anaesthetic efficiency;
inferior alveolar nerve block;
local anaesthesia;
mepivacaine;
third molar surgery
- From:Archives of Orofacial Sciences
2020;15(2):159-173
- CountryMalaysia
- Language:English
-
Abstract:
Mepivacaine is a common local anaesthetic used with claims of a high safety profile. There are two
commercial types, 2% mepivacaine with vasoconstrictor and 3% without vasoconstrictor. There
are many suggestions regarding the usage of plain 3% without vasoconstrictor for systemic medical
problems, however, there have not been any previous studies to confirm this necessity in impacted lower
third molar surgery (ILTMS). This study aims to evaluate the anaesthetic efficiency and the effect on
the patient of 2% and 3% mepivacaine, adding vasoconstrictor to the 3% mepivacaine. This crossover
study comprised of 24 patients with bilateral, symmetrically positioned, impacted lower third molars.
Patients received either 2% or 3% mepivacaine for the inferior alveolar nerve block (IANB). Onset
and duration of anaesthesia, and haemodynamic considerations were analysed as primary outcomes.
Furthermore, pain, duration of postoperative anaesthesia and pulp vitality were analysed as secondary
outcomes. Different concentrations of mepivacaine showed similar anaesthetic onset time (p > 0.05).
There was no statistically significant difference regarding the duration of anaesthesia, as well as the
postoperative analgesia (p > 0.05). The two concentrations did not lead to any haemodynamic changes
or complications during ILTMS. Thus, adding the vasoconstrictor to mepivacaine 3% did not cause any
adverse effects on the patients intra or postoperatively. Therefore, it is possible for dentists to use only
2% mepivacaine with vasoconstrictor for IANB effectively and safely when the case necessitates the need
for a vasoconstrictor, or in other words, longer duration of haemostasis.
- Full text:2.2020my198.pdf
