title: Anesthetic efficacy of different ropivacaine concentrations for inferior alveolar nerve block.
abstract: This study was conducted on 72 American Society of Anesthesiologists class 1 patients scheduled for extraction of a mandibular third molar after inferior alveolar nerve block. Each patient was randomly administered one of the following ropivacaine concentrations: 0.75%, 0.5%, 0.375%, or 0.25% (18 patients per group). Onset of block (mean +/- SD) was rapid for both 0.75% (1.4 +/- 0.4 minutes) and 0.5% (1.7 +/- 0.5 minutes) ropivacaine but significantly slower for the 0.375% (4.2 +/- 2.5 minutes) and 0.25% (10.7 +/- 3.0 minutes) concentrations. Tooth extraction was performed successfully with the 0.5% and 0.75% concentrations, and supplemental injections were not required. Second injections, however, were required with 0.375% ropivacaine. Anesthesia was unsuccessful in 13 patients given 0.25% ropivacaine even after 3 injections. The mean durations of soft tissue anesthesia were 3.3 +/- 0.3 hours and 3.0 +/- 0.3 hours for the 0.75% and 0.5% concentrations, but significantly shorter with more dilute concentrations. The duration of analgesia showed a similar pattern, with the 0.75% and 0.5% concentrations producing prolonged analgesia of 6.0 +/- 0.4 hours and 5.6 +/- 0.4 hours. These results indicate that 0.5% and 0.75% concentrations were effective for intraoral nerve blockade, with both a rapid onset and prolonged duration of pain control.
authors.affiliation: Faculty of Dentistry, Tanta University, Cairo, Egypt.
authors.forename: Eman
authors.initials: E
authors.lastname: El-Sharrawy
authors.forename: John A
authors.initials: JA
authors.lastname: Yagiela
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental; D000779:Anesthetics, Local / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008340:Mandibular Nerve / Q000187:drug effects*; D008964:Molar, Third / Q000601:surgery; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control; D000077212:Ropivacaine; D013997:Time Factors; D014081:Tooth Extraction
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine