Bupivacaine vs. lidocaine: a comparison of local anesthetic efficacy in impacted third molar surgery.

Abstract

The aim of this study was to compare the anesthetic efficacy, the duration of anesthesia, and the postoperative analgesia of lidocaine and bupivacaine and to determine any difference in hemodynamic parameters in patients who required impacted third molar removal. Thirty-eight patients between the ages of 18 and 40, with no systemic disease, were included in the study, with an indication of impacted lower third molar extraction. One of two local anesthetic agents (Marcaine and Jetokain Simplex) was randomly selected for tooth extractions. The parameters evaluated were the onset of anesthetic agent action, the duration of operation, the duration of postoperative analgesia, and postoperative visual analog scale scores. Hemodynamic parameters were observed and evaluated preoperatively and during the operation. All data were evaluated statistically. When the time of anesthesia onset was analyzed according to both anesthetic solutions, the difference was in favor of lidocaine (p = 0.01). The duration of action was longer in the bupivacaine group than in the lidocaine group (p = 0.00002). VAS values for the pain obtained during injection were lower in the lidocaine group (p = 0.009).However, according to the results of our study, the postoperative analgesic efficacy of bupivacaine is similar to that of lidocaine (p = 0.087). After evaluation of these results, we can recommend the use of lidocaine and bupivacaine safely in dentistry practice. But long-duration effect of bupivacaine and the rapid effect of lidocaine may make lidocaine more preferable. It is important to determine the clinically effective and safe anesthetic solution.