Maria Victoria Olmedo-Gaya1, Francisco Javier Manzano-Moreno2,3,4, Jose Luis Muñoz-López5, Manuel Francisco Vallecillo-Capilla1, Candela Reyes-Botella1,6,7. 1. Department of Stomatology, School of Dentistry, University of Granada, Colegio Máximo s/n, 18071, Granada, Spain. 2. Department of Stomatology, School of Dentistry, University of Granada, Colegio Máximo s/n, 18071, Granada, Spain. fjmanza@ugr.es. 3. Biomedical Group (BIO277), University of Granada, Granada, Spain. fjmanza@ugr.es. 4. Instituto Investigación Biosanitaria, ibs.Granada, Granada, Spain. fjmanza@ugr.es. 5. Master of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain. 6. Biomedical Group (BIO277), University of Granada, Granada, Spain. 7. Instituto Investigación Biosanitaria, ibs.Granada, Granada, Spain.
Abstract
OBJECTIVE: The objective of this randomized controlled clinical trial (RCT) was to compare the effect of bupivacaine and articaine at habitual doses on pain intensity and the need for analgesics after lower third molar extraction. MATERIALS AND METHODS: The final study sample comprised 50 Caucasian volunteers (26 males and 24 females; age range, 18-30 years) undergoing scheduled surgical extraction of impacted lower third molar. A computer-generated random sequence was used to allocate participants to the articaine (4%) or bupivacaine (0.5%) group. Surgeons and patients were blinded by labeling the articaine and bupivacaine carpules with numbers (1 and 2, respectively). Postoperative pain intensity (primary outcome) was evaluated with a visual analogue scale (VAS), while the requirement for and timing of rescue medication and the quality of intraoperative anesthesia were also measured (secondary outcomes). RESULTS:VAS-measured pain intensity was significantly higher (p < 0.05) in the articaine group than in the bupivacaine group at all time points except for 8 h post-surgery (p = 0.052). Rescue medication was required by 13 (52%) patients in the articaine group and 8 (32%) patients in the bupivacaine group, although the difference did not reach statistical significance (p = 0.252). The groups did not significantly differ (p = 0.391) in the quality of the intraoperative anesthesia. CONCLUSIONS:Bupivacaine is a valid alternative to articaine in third molar surgery and may offer residual anesthesia as a means of reducing postoperative pain. However, further well-designed RCTs are required in larger study populations to verify the effectiveness of bupivacaine to achieve residual analgesia after oral surgery. CLINICAL RELEVANCE: These findings suggest that bupivacaine may be useful as a coadjuvant to control acute postoperative pain. TRIAL REGISTRATION: ACTRN12617001138370.
RCT Entities:
OBJECTIVE: The objective of this randomized controlled clinical trial (RCT) was to compare the effect of bupivacaine and articaine at habitual doses on pain intensity and the need for analgesics after lower third molar extraction. MATERIALS AND METHODS: The final study sample comprised 50 Caucasian volunteers (26 males and 24 females; age range, 18-30 years) undergoing scheduled surgical extraction of impacted lower third molar. A computer-generated random sequence was used to allocate participants to the articaine (4%) or bupivacaine (0.5%) group. Surgeons and patients were blinded by labeling the articaine and bupivacaine carpules with numbers (1 and 2, respectively). Postoperative pain intensity (primary outcome) was evaluated with a visual analogue scale (VAS), while the requirement for and timing of rescue medication and the quality of intraoperative anesthesia were also measured (secondary outcomes). RESULTS: VAS-measured pain intensity was significantly higher (p < 0.05) in the articaine group than in the bupivacaine group at all time points except for 8 h post-surgery (p = 0.052). Rescue medication was required by 13 (52%) patients in the articaine group and 8 (32%) patients in the bupivacaine group, although the difference did not reach statistical significance (p = 0.252). The groups did not significantly differ (p = 0.391) in the quality of the intraoperative anesthesia. CONCLUSIONS:Bupivacaine is a valid alternative to articaine in third molar surgery and may offer residual anesthesia as a means of reducing postoperative pain. However, further well-designed RCTs are required in larger study populations to verify the effectiveness of bupivacaine to achieve residual analgesia after oral surgery. CLINICAL RELEVANCE: These findings suggest that bupivacaine may be useful as a coadjuvant to control acute postoperative pain. TRIAL REGISTRATION: ACTRN12617001138370.
Entities:
Keywords:
Acute pain; Articaine; Bupivacaine; Postoperative pain; Third molar surgery
Authors: Hossein Ghaeminia; John Perry; Marloes E L Nienhuijs; Verena Toedtling; Marcia Tummers; Theo J M Hoppenreijs; Wil J M Van der Sanden; Theodorus G Mettes Journal: Cochrane Database Syst Rev Date: 2016-08-31
Authors: M-A Vílchez-Pérez; M Sancho-Puchades; E Valmaseda-Castellón; J Paredes-García; L Berini-Aytés; C Gay-Escoda Journal: Med Oral Patol Oral Cir Bucal Date: 2012-03-01