4% Articaine and 2% Lignocaine for Surgical Removal of Third Molar by Mandibular Nerve Block: A Randomized Clinical Trial for Efficacy and Safety
- 24 Downloads
Articaine entered clinical use in 1976; however, evidence basis for articaine’s reputation is not entirely clear. The aim of the study is to compare and analyze 4% articaine with 1:100,000 epinephrine and 2% lignocaine with 1:100,000 epinephrine in patients operated for mandibular third molar impaction with respect to efficacy and safety, time of onset and duration of anesthesia and duration of postoperative analgesia.
The study was done on fifty patients requiring surgical extraction of mandibular third molar; randomly divided into two groups of 25 each, receiving 4% articaine hydrochloride with 1:100,000 epinephrine and 2% lignocaine hydrochloride with 1:100,000 epinephrine. Difficulty index for extraction, volume, onset and duration of anesthesia and duration of postoperative analgesia were recorded. Pain was assessed using Heft-Parker VAS. The data were analyzed using appropriate statistical analysis.
The mean onset time for articaine and lignocaine is 3.16 ± 0.55 and 3.2 ± 0.48 min, respectively. Articaine group experienced statistically significant longer period of analgesia and duration of action 289.04 ± 40 and 361.88 ± 40 min, respectively, as compared to lignocaine which is 144.2 ± 12 and 197.44 ± 25 min, respectively. No statistical difference between the two groups with regard to pain experience.
4% Articaine is more potent and has longer duration of action with better postoperative analgesia and could be considered as an alternative to lignocaine in clinical practice. With management of postoperative pain being the critical component of patient care, clinical trials are required to develop long acting local anesthetic with increased postoperative analgesia effect.
Keywords4% Articaine hydrochloride 2% Lignocaine hydrochloride Postoperative analgesia
Author would like to thank Dr. Srinath Thakur, Principal, SDM College of Dental Sciences Dharwad and Dr. Niranjan Kumar, Medical Director, SDM Craniofacial Research Centre, Dharwad for the encouragement and facilities provided. Author would also thank Dr. Abhijit Joshi, Associate Professor, Department of Oral and Maxillofacial Surgery, SDM College of Dental Sciences Dharwad for his constant support.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval taken by the Institutional Review Board (IRB No. 2013/P/OS/22).
- 3.Kalia V, Supreet, Kaur R (2011) Comparitive evaluation of onset and duration of anesthesia of 4% articaine versus 2% lidocaine with epinephrine 1:100000 during exodontia. Indian J Compr Dent Care 1(1):19–24Google Scholar
- 10.Malamed SF, Gagnon S, Leblanc D (2005) Efficacy of articaine: a new amide local anesthetic. Quintessence Int 36(3):197–201Google Scholar
- 11.Rebolledo AS, Molina ED, Aytés LB et al (2007) Comparative study of the anesthetic efficacy of 4% articaine versus 2% lidocaine in inferior alveolar nerve block during surgical extraction of impacted lower third molars. Med Oral Patol Oral Cir Bucal 12:139–144Google Scholar
- 15.Malamed SF (2004) Hand book of local anesthesia, 5th ed, Chapter 4. Elsevier Mosby, St. Louis Missouri, pp 55–63Google Scholar
- 20.Chawla J, Pandilwar PK, Kumar P, Sonowal ST (2016) Comparison of anesthetic efficacy of 4% articaine with 2% lignocaine in surgical extraction of mandibular third molars: a double blinded randomised controlled clinical trial. Int J Curr Res 8(9):39066–39070Google Scholar