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http://dx.doi.org/10.17245/jdapm.2021.21.4.337

Comparison of clinical efficacy of ropivacaine and lignocaine with adrenaline for implant surgery anesthesia: a split-mouth randomized controlled clinical trial  

Kalath, Remya Nath (Department of Periodontology, Rajarajeswari Dental College and Hospital)
Kulal, Rithesh (Department of Periodontology, Rajarajeswari Dental College and Hospital)
Gopinath, Sharika (Department of Periodontology, Rajarajeswari Dental College and Hospital)
Publication Information
Journal of Dental Anesthesia and Pain Medicine / v.21, no.4, 2021 , pp. 337-344 More about this Journal
Abstract
Background: The primary indication for using long-acting anesthetics in dentistry is extensive dental procedures that require pulpal anesthesia beyond 90 min and management of postoperative pain. Ropivacaine is an amide local anesthetic that is available at various concentrations with inherent vasoconstrictive properties at low concentrations. Ropivacaine has a 75% greater margin of safety than bupivacaine. Ropivacaine can be a good alternative to bupivacaine as a local anesthetic in dental implant surgery as it provides a longer duration of both pulpal and soft tissue anesthesia after mandibular nerve block and lowers CNS and cardiovascular toxicity. This study aimed to evaluate and compare the clinical efficacy of ropivacaine and lignocaine for implant surgery anesthesia. Methods: Fifteen patients with bilateral edentulous sites indicated for implant placement were recruited for this study. Patients aged 20-60 years of both sexes were randomly recruited. Thirty implant placements were performed in the test and control groups using ropivacaine and lignocaine with adrenaline as local anesthetics, respectively. Results: The results were analyzed statistically. The duration of anesthesia was significantly higher in the test group than in the control group. Ropivacaine was found to be superior to lignocaine in terms of the quality of anesthesia. The comparison of mean visual analog scale scores showed ropivacaine to have better anesthetic and analgesic effects than the control group. Conclusion: Ropivacaine 0.75% provides a significantly longer duration of anesthesia than lignocaine 2% with adrenaline. Ropivacaine 0.75% decreased intraoperative and postoperative analgesia compared to lignocaine 2% with adrenaline. Hence, ropivacaine 0.75% can be used as an alternative to lignocaine in implant surgeries and other intraoral surgical procedures that require a longer duration of anesthesia and analgesia.
Keywords
Dental Implants; Lignocaine; Local Anesthesia; Receptor Theory; Ropivacaine;
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1 El-Sharrawy E, Yagiela JA. Anesthetic efficacy of different ropivacaine concentrations for inferior alveolar nerve block. Anesth Prog 2006; 53: 3-7.   DOI
2 Kuthiala G, Chaudhary G. Ropivacaine: a review of its pharmacology and clinical use. Indian J Anaesth 2011; 55: 104-10.   DOI
3 Knudsen K, Beckman Suurkula M, Blomberg S, Sjovall J, Edvardsson N. Central nervous and cardiovascular effects of IV infusions of ropivacaine, bupivacaine and placebo in volunteers. Br J Anaesth 1997; 78: 507-14.   DOI
4 Brkovic BM, Zlatkovic M, Jovanovic D, Stojic D. Maxillary infiltration anesthesia by ropivacaine for upper third molar surgery. Int J Oral Maxillofac Surg 2010; 39: 36-41.   DOI
5 Ranjan R, Santhosh Kumar SN, Singh M. Comparison of efficacy of 0.75% ropivacaine and 2% lidocaine with 1:200,000 adrenaline in pain control in extraction of mandibular posterior teeth: a double-blind study. Indian J Dent Res 2018; 29: 611-5.   DOI
6 Rajpari KN, Andrade NN, Nikalje T. Comparison of anesthetic efficacy of ropivacaine (0.75% & 0.5%) with 2% lignocaine with adrenaline (1:200000) in surgical extraction of bilateral mandibular 3rd molars using IANB:a prospective, randomized, single blind study. J Oral Biol Craniofac Res 2021; 11: 263-8.   DOI
7 Paxton K, Thome DE. Efficacy of articaine formulations: quantitative reviews. Dent Clin North Am 2010; 54: 643-53.   DOI
8 Bansal V, Kumar D, Mowar A, Bansal A. Comparison of ropivacaine 0.75% and lignocaine 2% with 1:200,000 adrenaline in dental extractions: single blind clinical trial. J Maxillofac Oral Surg 2018; 17: 201-6.   DOI
9 Budenz AW. Local anesthetics in dentistry: then and now. J Calif Dent Assoc 2003; 31: 388-96.
10 Gordon SM, Mishenko AV, Dionne RA. Long acting local anesthetics and perioperative pain management. Dent Clin North Am 2010; 54: 611-20.   DOI
11 Mansour NA, Belasy, Marzook HA. Ropivacaine versus bupivacaine in postoperative pain control. J Biotechnol Biomater 2012; 2: 137-44.
12 French J, Sharp LM. Local anaesthetics. Ann R Coll Surg Engl 2012; 94: 76-80.   DOI
13 Sisk AL. Long-acting local anesthetics in dentistry. Anesth Prog 1992; 39: 53-60.
14 Kennedy M, Reader A, Beck M, Weaver J. Anesthetic efficacy of ropivacaine in maxillary anterior infiltration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 91: 406-12.   DOI
15 Ernberg M, Kopp S. Ropivacaine for dental anesthesia: a dose-finding study. J Oral Maxillofac Surg 2002; 60: 1004-10.   DOI
16 Budharapu A, Sinha R, Uppada UK, Subramanya Kumar AV. Ropivacaine: a new local anesthetic agent in maxillofacial surgery. Br J Oral Maxillofac Surg 2015; 53: 451-4.   DOI