Comparative Analysis of the Anesthetic Efficacy of 0.5 and 0.75% Ropivacaine for Inferior Alveolar Nerve Block in Surgical Removal of Impacted Mandibular Third Molars.

Abstract

Ropivacaine belongs to pipecoloxylidide group of local anesthetics. There are reports supporting the use of ropivacaine as a long acting local anesthetic in oral and maxillofacial surgical procedures, with variable data on the concentration that is clinically suitable. A prospective randomized double-blind study protocol was undertaken to assess the efficacy of 0.5 and 0.75% ropivacaine for inferior alveolar nerve block in surgical extraction of impacted mandibular third molars. A total of 60 procedures were performed, of which thirty patients received 0.5% and thirty received 0.75% concentration of the study drug. All the patients in both the study groups reported subjective numbness of lip and tongue. The time of onset was longer for 0.5% ropivacaine when compared to 0.75% solution. 90% of the study patients in 0.5% ropivacaine group reported pain corresponding to VAS ≥3 during bone guttering and 93.3% patients reported pain corresponding to VAS >4 during tooth elevation. None of the patients in 0.75% ropivacaine group reported VAS >3 at any stage of the surgical procedure. The duration of soft tissue anesthesia recorded with 0.75% ropivacaine was average 287.57±42.0min. 0.75% ropivacaine was found suitable for inferior alveolar nerve blocks in surgical extraction of impacted mandibular third molars.