A comparison of ropivacaine and lidocaine with epinephrine for intraligamentary anesthesia.
OBJECTIVE
The purpose of this study was to compare the efficacy of 2 different concentrations of ropivacaine with lidocaine containing epinephrine for intraligamentary anesthesia.


METHODS
Ethical approval was obtained and a randomized, double-blind, cross-over volunteer investigation was conducted. Twenty-four volunteers had intraligamentary injections of 2% lidocaine with 1:80,000 epinephrine, 0.75% ropivacaine, or 1% ropivacaine at the upper lateral incisor and lower first bicuspid teeth. The response of the test teeth to electrical pulp testing and the reaction of the gingiva to sharp probing were assessed up to 29 minutes after injection. Injection discomfort and side effects were also recorded. Data were analyzed by using the chi-square test and analysis of variance.


RESULTS
Lidocaine with epinephrine was more successful than the ropivacaine solutions in obtaining pulpal anesthesia (chi-square = 12; P <.002) and produced longer-lasting pulpal (F = 21; P <.001) and soft tissue (F = 16; P <.001) anesthesia. Injection discomfort and incidence of side effects were similar between solutions, and none produced serious adverse effects.


CONCLUSIONS
Lidocaine with epinephrine is more effective than ropivacaine as an intraligamentary anesthetic.
Meechan
J G
JG
Department of Oral and Maxillofacial Surgery, University of Newcastle Upon Tyne, United Kingdom. J.G.Meechan@ncl.ac.uk
D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000704:Analysis of Variance; D000766:Anesthesia, Dental; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001641:Bicuspid / Q000187:drug effects; D016009:Chi-Square Distribution; D018592:Cross-Over Studies; D003782:Dental Pulp / Q000187:drug effects; D003791:Dental Pulp Test; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005881:Gingiva / Q000187:drug effects; D006801:Humans; D007180:Incisor / Q000187:drug effects; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D010147:Pain Measurement; D010513:Periodontal Ligament; D000077212:Ropivacaine; D013269:Stochastic Processes; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D000577:Amides; D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D000077212:Ropivacaine; D008012:Lidocaine; D004837:Epinephrine