Comparison of Efficacy of 4% Articaine and 0.5% Bupivacaine and 2% Lignocaine Anaesthetic agents in Orthodontic Extractions-A Prospective Randomised Controlled Study

Abdul Wahab,P Senthil Murugan,Yandeti Srinivasulu

doi:10.9734/jpri/2021/v33i41b32349

Abdul Wahab, P Senthil Murugan + Show 1 more

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https://doi.org/10.9734/jpri/2021/v33i41b32349

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Abstract

Aim: Articaine, bupivacaine, lignocaine are amide type of local anesthetic agents, which are of almost equal potency. However, lidocaine is considered the gold standard and is the most widely used anesthetic agent because of its potency, safety, and efficiency. Articaine is fast acting and bupivacaine is long lasting local anaesthesia. The aim of this clinical study was to evaluate and compare the clinical anesthetic efficacy of 4% articaine and 0.5% bupivacaine and 2% lignocaine in therapeutic orthodontic extractions. Materials and Methods: A 150 healthy patients, requiring Maxillary premolars extraction for orthodontic reasons were included. Patients were categorized into three groups (4% articaine and 0.5% bupivacaine, 2% lignocaine) in a crossover manner. Subjective and objective observations recorded that include age, gender, and pain score using visual analog scale. At the first appointment, both upper premolars were extracted on one or two sides of the jaws. Each patient was evaluated using a visual analogue scale. Results: The results showed that 0.5% Bupivacaine had significantly faster onset of action and lower visual analogue scores when compared with articaine and lignocaine. However, the duration of analgesia and need of first rescue analgesic medication was longer in the bupivacaine group. Conclusion: Within the limitations of study we found that Bupivacaine has the best anaesthetic effect with low pain scores followed by Articaine and followed by Lignocaine. Bupivacaine is an alternative local anaesthetic drug for performing therapeutic orthodontic extractions.

Highlights

Aim: Articaine, bupivacaine, lignocaine are amide type of local anesthetic agents, which are of almost equal potency
The results showed that 0.5% Bupivacaine had significantly faster onset of action and lower visual analogue scores when compared with articaine and lignocaine
The duration of analgesia and need of first rescue analgesic medication was longer in the bupivacaine group

Summary

Introduction

Local anesthesia and pain management are the most important tenets in any oral surgical procedure. Patient compliance and effective surgical procedure mandates complete pain control in order to gain patient cooperation and manage patient anxiety. Local anaesthetics are believed to be the most frequently used drugs in clinical dentistry. Until the beginning of the twentieth century, cocaine was the drug of choice for surgical and dental pain control despite its significant limitations such as its low therapeutic index, the risk of addiction and potentially lethal arrhythmias.After its synthesis in 1904 by Alfred Einhorn procaine became the main local anesthetic in medicine and dentistry. Because of the long latency period of procaine and allergies to ester anesthetics, lidocaine, the first amide anesthetic, quickly became the gold standard after its synthesis in 1943 by Nils Lofgren. Its main indications are lengthy procedures and postoperative pain management [4]

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