Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons | 2021
Twin Mixed Local Anesthesia in Third Molar Surgery - Randomized Controlled Trial.
Abstract
PURPOSE\nThe aim of this study was to compare the clinical efficacy of injection of 2 long-acting amide local anesthetic agents - bupivacaine and ropivacaine with and without 4 mg dexamethasone in patients undergoing third molar extraction.\n\n\nMETHODS\nA prospective randomized double blind controlled trial was conducted amongst 68 patients with impacted mandibular third molars. Group A and B were the control groups and received 1.8 mL of 0.5% bupivacaine hydrochloride and 0.75% ropivacaine hydrochloride, respectively. Group A1 and B1 were experimental groups and received modified twin mixes which were 1.8 mL of 0.5% bupivacaine hydrochloride\u202f+\u202f1mL/4mg dexamethasone and 0.75% ropivacaine hydrochloride\u202f+\u202f1 mL/4mg dexamethasone, respectively. Visual analog pain scale, mouth opening measurement and facial swelling were assessed at the time of injection and postoperative days 1, 3, and 7.\n\n\nRESULTS\nThe mean VAS score for pain on LA injection was found to be less in both experimental groups- Group A1 (2.94) and B1 (2.41) as compared to control groups- Group A (3.59) and B (3.06). The durations of soft tissue anesthesia were higher as compared to their respective controls for both Group A1 and B1. Patients in both control groups A and B had an increased postoperative swelling, pain and trismus.\n\n\nCONCLUSIONS\nIntraoperative and postoperative comfort in both the experimental groups were higher than those for control groups, thereby establishing the clinical efficacy of both modified twin mixes for use in surgical extraction of mandibular third molars.