Effect of the addition of a vasoconstrictor to local anesthetic solution on operative and postoperative bleeding, analgesia and wound healing.

A clinical study of local anesthetic solutions with and without epinephrine was conducted involving 32 healthy adults requiring removal of bony impacted mandibular third molars. The time elapsing from the administration of the anesthetic solution until analgesia was obtained was significantly shorter in the vasoconstrictor group (P less than 0.001). Additional anesthetic was necessary in 44% of the patients in the control group. The blood loss in the vasoconstrictor group was significantly lower (P less than 0.001) than in the group receiving anesthetic solution without the vasoconstrictor. No statistically significant difference in operation time between the groups was found, although the profuse bleeding in the control group impeded to some extent the surgical procedure. A positive correlation coefficient between operation time and blood loss of r = 0.65 in the vasoconstrictor group (P less than 0.006) and r = 0.77 in the control group (P less than 0.001) was found. Hemorrhage occurring 24 h postoperatively was recorded in 37% of the subjects in the vasoconstrictor group, and of these 83% revealed a healing of the socket by second intention.