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Is amalgamated ligno-bupivacaine an answer to complicated minor oral surgical anesthesia? A randomized split-mouth double-blind clinical trial

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Abstract

Purpose

The purpose of this study was to find a suitable anesthetic combination for complicated and protracted minor oral surgical procedures.

Methods

Fifty patients with bilaterally impacted deep-seated mandibular third molars were included in this study and randomly divided on the basis of anesthetic used into two groups. Group A received 2% lignocaine with 1:200,000 adrenaline while in group B, amalgamated mixture of 2% lignocaine and 0.5% bupivacaine was used. The onset time, duration of anesthetic effect, supplementary injections, pain (during local anesthetic deposition, intra and postoperatively), and postoperative analgesia were the study parameters. Chi-square and unpaired t tests were used to compare means.

Results

The onset time in both the groups was comparable and showed statistically significant difference between the duration of anesthetic effect with notable requirement of supplemental anesthetic injections in group A (54%) (p < 0.05). Pain scores also revealed a statistically significant intergroup difference (p < 0.05). Requirement of postoperative analgesics was delayed in group B.

Conclusions

The amalgamated mixture of lignocaine and bupivacaine had equivocally rational onset and provided a more profound and in-depth anesthesia especially in complicated and protracted minor oral surgical procedures. Though this mixture is widely used in other surgical fields, its efficacy still remains unexploited and undocumented in oral and maxillofacial surgical procedures.

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Abbreviations

CBCT:

Cone beam computed tomography

OPG:

Orthopantomogram

IAN:

Inferior alveolar nerve

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India

    Akshay Mishra, Monica Mahajan, Chandrashekhar Bande, Ajit Joshi, Mayur Gawande & M. K. Gupta

Authors
  1. Akshay Mishra
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  2. Monica Mahajan
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  3. Chandrashekhar Bande
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  4. Ajit Joshi
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  5. Mayur Gawande
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  6. M. K. Gupta
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Corresponding author

Correspondence to Akshay Mishra.

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Conflict of interest

Dr. Akshay Mishra, Dr. Monica Mahajan, Dr. C. R. Bande, Dr. Ajit Joshi Dr. Mayur Gawande, and Dr. M. K. Gupta declare that they have no conflict of interest.

Patient informed consent

Informed consent was taken from all the participants who agreed to be a part of this study.

Ethical approval

Ethical approval was given by Institutional Research and Ethical Committee (Institutional Review Board). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

DRUGS

- LOX 2% adrenaline 1: 200,000 (lignocaine hydrochloride and adrenaline bitartrate injection I.P. manufactured by Neon Laboratories Limited; 28 Mahal Ind. Est., M. Caves Road, Andheri (East), Mumbai-400093)

- LOX 2% (lignocaine hydrochloride injection I.P. manufactured by Neon Laboratories Limited; 28 Mahal Ind. Est., M. Caves Road, Andheri (East), Mumbai-400093)

- ANAWIN 0.5% (bupivacaine hydrochloride injection I.P. manufactured by Neon Laboratories Limited; 28 Mahal Ind. Est., M. Caves Road, Andheri (East), Mumbai-400093)

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Mishra, A., Mahajan, M., Bande, C. et al. Is amalgamated ligno-bupivacaine an answer to complicated minor oral surgical anesthesia? A randomized split-mouth double-blind clinical trial. Oral Maxillofac Surg 22, 97–104 (2018). https://doi.org/10.1007/s10006-018-0676-z

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  • DOI: https://doi.org/10.1007/s10006-018-0676-z

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