Journal of Maxillofacial and Oral Surgery

, Volume 13, Issue 4, pp 431–434 | Cite as

Comparative Analysis of the Anesthetic Efficacy of 0.5 and 0.75 % Ropivacaine for Inferior Alveolar Nerve Block in Surgical Removal of Impacted Mandibular Third Molars

  • Darpan Bhargava
  • Nupur Chakravorty
  • Elangovan Rethish
  • Ashwini Deshpande
Research Paper



Ropivacaine belongs to pipecoloxylidide group of local anesthetics. There are reports supporting the use of ropivacaine as a long acting local anesthetic in oral and maxillofacial surgical procedures, with variable data on the concentration that is clinically suitable.

Materials and Methods

A prospective randomized double-blind study protocol was undertaken to assess the efficacy of 0.5 and 0.75 % ropivacaine for inferior alveolar nerve block in surgical extraction of impacted mandibular third molars. A total of 60 procedures were performed, of which thirty patients received 0.5 % and thirty received 0.75 % concentration of the study drug.


All the patients in both the study groups reported subjective numbness of lip and tongue. The time of onset was longer for 0.5 % ropivacaine when compared to 0.75 % solution. 90 % of the study patients in 0.5 % ropivacaine group reported pain corresponding to VAS ≥3 during bone guttering and 93.3 % patients reported pain corresponding to VAS >4 during tooth elevation. None of the patients in 0.75 % ropivacaine group reported VAS >3 at any stage of the surgical procedure. The duration of soft tissue anesthesia recorded with 0.75 % ropivacaine was average 287.57 ± 42.0 min.


0.75 % ropivacaine was found suitable for inferior alveolar nerve blocks in surgical extraction of impacted mandibular third molars.


Ropivacaine Local anesthesia Oral surgery Dental Inferior alveolar nerve block 


  1. 1.
    All-Atabakhsh A, Rosenberg MB (2012) Ropivacaine: the next dental local anesthetic? J Mass Dent Soc 61:14–16PubMedGoogle Scholar
  2. 2.
    McClure JH (1996) Ropivacaine. Br J Anaesth 76:300–307PubMedCrossRefGoogle Scholar
  3. 3.
    McClellan KJ, Faulds D (2000) Ropivacaine: an update of its use in regional anaesthesia. Drugs 60:1065–1093PubMedCrossRefGoogle Scholar
  4. 4.
    Ernberg M, Kopp S (2002) Ropivacaine for dental anesthesia: a dose-finding study. J Oral Maxillofac Surg 60:1004–1010PubMedCrossRefGoogle Scholar
  5. 5.
    Axelsson S, Isacsson G (2004) The efficacy of ropivacaine as a dental local anaesthetic. Swed Dent J 28:85–91PubMedGoogle Scholar
  6. 6.
    El-Sharrawy E, Yagiela JA (2006) Anesthetic efficacy of different ropivacaine concentrations for inferior alveolar nerve block. Anesth Prog 53:3–7PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Malamed SF (2004) Handbook of local anesthesia, Mosby, St. Louis, 5th ednGoogle Scholar
  8. 8.
    Kirkman TW (1996) Statistics to use. Accessed 26 July 2012
  9. 9.
    Brkovic BM, Zlatkovic M, Jovanovic D, Stojic D (2010) Maxillary infiltration anaesthesia by ropivacaine for upper third molar surgery. Int J Oral Maxillofac Surg 39:36–41PubMedCrossRefGoogle Scholar

Copyright information

© Association of Oral and Maxillofacial Surgeons of India 2013

Authors and Affiliations

  • Darpan Bhargava
    • 1
    • 5
  • Nupur Chakravorty
    • 2
  • Elangovan Rethish
    • 3
  • Ashwini Deshpande
    • 4
  1. 1.Department of Oral and Maxillofacial Surgery, Peoples College of Dental Sciences and Research CenterPeoples UniversityBhopalIndia
  2. 2.Department of AnesthesiologyL.N Medical College and Research Center and J.K HospitalBhopalIndia
  3. 3.Department of Oral and Maxillofacial SurgeryVinayaka Mission’s Sankarachariyar Dental College and HospitalSalemIndia
  4. 4.Department of Oral Medicine and RadiologyPeople’s Dental AcademyBhopalIndia
  5. 5.BhopalIndia

Personalised recommendations