“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.