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Abstract
Background: Perineurally adding dexamethasone to local anesthetics could enable postoperative analgesia. Our aim was to investigate the efficacy of 4 mg dexamethasone and 0.5% ropivacaine on the prolonged duration of mandibular anesthesia for postoperative analgesia during third molar surgery. Materials and method: The patients of both sexes, and in the age range of 17 to 50 yrs of age, received the Gow-Gates anesthesia. Group I received 4 mL of plain 0.5% ropivacaine, with perineurally added 1 mL/4 mg of dexamethasone; group II received 4 mL of plain 0.5% ropivacaine with perineurally added 1 mL of 0.9% saline; group III received 4 mL of plain 0.5 bupivacaine with perineurally added 1 mL of 0.9% saline. The prime anesthesia outcome was the duration of conduction anesthesia (DCA); the secondary outcome was the duration of analgesia (DAN) and analgesia before analgesic intake. Results: In 45 randomly selected subjects (mean age 27.06 ± 8.20), DCA was statistically longest in group I (n = 15) (592.50 ± 161.75 min, p = 0.001), collated with groups II (n = 15) and III (n = 15) (307.40 ± 84.71 and 367.07 ± 170.52 min, respectively). DAN was significantly the longest in group I (mean: 654.9 ± 198.4 min, p = 0.001), compared with group II (345.4 ± 88.0 min) and group III (413.7 ± 152.3 min), with insignificant adverse reactions. One-third of the operated patients absented from the use of analgesics. Conclusion: A amount 0.5% ropivacaine with dexamethasone usefully served as an analgesic with a success rate of 93.4% of the given anesthesia.
Highlights
Introduction published maps and institutional affilPain is the most frequent and most experienced discomfort after oral surgery, especially after lower third molar surgery [1], which is performed in everyday oral and maxillofacial ambulatory praxis [2]
To the best of our knowledge, we have found a lack of oral and maxillofacial literature data reporting on the beneficial effects of dexamethasone, in combination with ropivacaine, on prolonged anesthesia and enabling sufficiently long postoperative analgesia for the purpose of enabling the patient to experience a postoperative pain-free period without analgesic medication intake; in addition, it would be desirable to achieve profound inferior alveolar nerve block (IANB) anesthesia with a high success rate
The primary and secondary local anesthesia outcomes during lower impacted third molar surgery were registered in patients who had received plain 0.5% ropivacaine with the perineural adding of 4 mg dexamethasone, plain 0.5% ropivacaine and plain 0.5% bupivacaine
Summary
Pain is the most frequent and most experienced discomfort after oral surgery, especially after lower third molar surgery [1], which is performed in everyday oral and maxillofacial ambulatory praxis [2]. This unpleasant clinical outcome, which is the consequence of surgery, is mainly provoked by the pathological influence of the released mediators of pain (histamine, serotonin, kinin and prostaglandins), triggered by the locally surgically damaged dentoalveolar tissue [3], occurring up to 5 h after surgery upon the cessation of the local anesthetic’s efficacy [4]. Ropivacaine is used as a long-lasting amid anesthetic in various types of oral surgery practice iations
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