Comparative Evaluation of the Anesthetic Efficacy of 1% Chloroprocaine Vis-a-vis 2% Lignocaine with Adrenaline (1:80,000) in Third Molar Surgery.

Abstract

To evaluate the anesthetic efficacy of 1% chloroprocaine in comparison to 2% lignocaine hydrochloride and adrenaline (1:80,000) in third molar surgery. A randomized single-blind trial comprising of 30 healthy patients requiring bilateral extraction of impacted lower third molars with similar difficulty index was undertaken. A test dose was administered to all patients with subdermal infiltration of 1% chloroprocaine with 0.5ml. A classic inferior alveolar and long buccal nerve block was given using 1% chloroprocaine 2ml on one side and 2% lignocaine hydrochloride 2ml with adrenaline on the other side. The time to onset and duration of action were noted. Pain during the surgical intervention, need for additional local anesthetic solution during the surgical intervention and the hemodynamic changes associated with the administration of the drugs were monitored. Chloroprocaine had an early onset of action with a mean of 1.17 ± 0.55min as compared to lignocaine 4.2 ± 0.48min. Patients administered with lignocaine experienced less postoperative pain compared with chloroprocaine since the duration of action of chloroprocaine was lesser than that of lignocaine. Additional amount of LA was required when chloroprocaine was administered as compared to lignocaine. Chloroprocaine alone did not cause any appreciable changes in the hemodynamics, but lignocaine with adrenaline caused a transient increase in arterial pressure and heart rate 2min following the administration. It was also observed that more blood was lost following chloroprocaine administration than with lignocaine. Chloroprocaine has a rapid onset of action and short duration of action with minimal effects on the hemodynamic changes than lignocaine. Considering the fact that it is a safe drug with no effects of the cardiovascular system it can be advocated that Chloroprocaine can be used as an effective local anesthetic agent for performing oral and maxillofacial surgical interventions of short duration.