A Comparison of the Postoperative Pain Relief and Clinical Local Anesthetic Efficacy of Levobupivacaine and Articaine for Impacted Lower Third Molar Removal

Abstract

Objective: A comparison of postoperative pain relief and clinical anesthetic efficacy of 2% articaine and 0.5% levobupivacaine in impacted third molar dental surgery. Material-Method: Fifty-three patients underwent the removal of symmetrically positioned lower third molars in 2 separate appointments under local anesthesia either with 2% articaine or 0.5% levobupivacaine in a double-blinded, randomized and crossover study. Neither anesthetic agent contained a vasoconstrictor. The time to onset of anesthesia, duration of surgery, intraoperative bleeding, hemodynamic parameters, the duration of postoperative analgesia and anesthesia as well as postoperative visual analogue scale (VAS) scores were evaluated.Results: The time to onset of anesthesia with articaine (80.28 ± 19.27 seconds) was significantly less compared to levobupivacaine (136.69 ± 33.52 seconds). The average duration of postoperative anesthesia for levobupivacaine and articaine was 8 hours and 3 hours, respectively (p = 0.000). The mean duration of postoperative analgesia for levobupivacaine and articaine was 7-8 hours and 3 hours, respectively (p = 0.000). Additionally, VAS scores with levobupivacaine were significantly lower than articaine up to the 4th postoperative hour. Significantly less bleeding was seen in the surgeries performed with levobupivacaine.Conclusion: 0.5% Levobupivacaine resulted in a longer period of postoperative anesthesia and analgesia, a longer time to onset of anesthesia, and less postoperative pain compared to 2% articaine.