Topical bupivacaine for pain control following simple dental extractions.
OBJECTIVE
This study was carried out to examine the effectiveness of topically applied bupivacaine 0.25% with adrenaline 1:200,000, for post-operative analgesia in children undergoing dental extractions under general anaesthesia.


METHODS
Randomised double blind study in a single centre.


METHODS
An outpatient dental clinic in a district general hospital, in England, in 1997.


METHODS
Subjects were selected from children of age 7-15 years having six or less extractions, and randomised using the closed envelope technique.


METHODS
The local anaesthetic used was bupivacaine 0.25% with adrenaline 1:200,000.


METHODS
Children were asked on waking from the anaesthetic whether they had pain or not. Pain was reassessed five and ten minutes post application of swabs to determine any changes in pain.


RESULTS
Forty-eight children were recruited, of these 18 had no pain post-operatively and 6 were withdrawn due to a lack of cooperation. Twelve children were randomised to each group. There were 6 boys and 6 girls in the bupivacaine group (age 7-15 years), and 4 boys and 8 girls in the saline group. Bupivacaine 0.25% with adrenaline soaked swabs resulted in a significant reduction in pain in 10 children at 10 minutes (P = 0.01).


CONCLUSIONS
Bupivacaine 0.25% with adrenaline 1:200,000, on application to exposed sockets is a simple technique that may provide useful post-operative analgesia.
Greengrass
S R
SR
Rotherham District General Hospital.
Andrzejowski
J
J
Ruiz
K
K
D000287:Administration, Topical; D000293:Adolescent; D000556:Ambulatory Surgical Procedures; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D012965:Sodium Chloride; D014081:Tooth Extraction; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D000700:Analgesics; D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D012965:Sodium Chloride; D002045:Bupivacaine; D004837:Epinephrine