Bupivacaine: a long-lasting local anesthetic for dentistry.

Bupivacaine, a long-acting amide local anesthetic, is a chemical analogue of mepivacaine with high lipid-solubility and protein-binding characteristics. These properties contribute to bupivacaine's greater potency and anesthetic duration as compared to other local anesthetics used in dentistry. The prolonged anesthesia it produces has been shown to limit postoperative pain following third molar extractions and endodontic procedures. Bupivacaine 0.5% with 1:200,000 epinephrine provides a safe and valuable alternative to the anesthetic agents presently available in dentistry.