“COMPARISON OF CLINICAL EFFICACY OF ROPIVACAINE AND LIGNOCAINE WITH ADRENALINE FOR IMPLANT SURGERY ANAESTHESIA- A SPLIT MOUTH RANDOMIZED CONTROLLED CLINICAL TRIAL.”
ABSTRACT :-
INTRODUCTION: The primary indications for utilization of long acting local anesthetics in dentistry: lengthy dental procedures for which pulpal anesthesia in excess of 90 minutes is necessary and management of postoperative pain. Ropivacaine is a local anesthetic of the amide type that chemically is homologous to bupivacaine and mepivacaine. It is available in various concentrations (0.75%, 0.5%, 0.375%, or 0.25%) and is said to have inherent vasoconstrictive properties at low concentrations. Ropivacaine has 75% greater margin of safety than bupivacaine. Due to its long duration of both pulpal and soft tissue anesthesia after mandibular nerve block and a lower CNS and cardiovascular toxicity, ropivacaine can be a good alternative to bupivacaine as a local anaesthetic in dental implant surgery. The aim of the study was to evaluate and compare the clinical efficacy of ropivacaine to lignocaine for implant surgery anaesthesia. To assess the onset and duration of anaesthesia the intraoperative and post-operative pain with both local anaesthetics and the post-operative analgesics requirement.
MATERIALS AND METHODS:- The present study was carried out in a total of 15 subjects with age range of 20 -60 years, reporting to the Department of Implantology, Rajarajeswari Dental College and Hospital, Bangalore 15 Healthy patients with bilateral missing teeth indicated for implant placement were randomly selected of both sexes (male and female) between age group of 20-60 years. The test group involves implant surgeries in which ropivacaine was used. The control group involves implant surgeries in which lignocaine with adrenaline were used.
RESULTS -The results were statistically analysed. There was a statistically significant higher duration of anesthesia for the test group as compared to the control group. Ropivacaine was found to be superior to lignocaine as far as quality of anesthesia was concerned. The comparison of mean VAS scores showed that ropivacaine has better anesthetic and analgesic effect when compared to the control group.
CONCLUSION: Ropivacaine 0.75% provides significantly longer duration of anesthesia than lignocaine 2% with adrenaline. Ropivacaine 0.75% decreases the intraoperative and postoperative analgesia compared to lignocaine 2% with adrenaline. Thus, efficacy of ropivacaine 0.75% is superior to lignocaine 2% with 1:200,000 adrenaline in terms of duration of anesthesia and analgesia. Hence, ropivacaine 0.75% can be used as an alternative to lignocaine in implant surgeries and other surgical procedures which require longer duration of anesthesia and analgesia intraorally.