title: Ropivacaine: a new local anaesthetic agent in maxillofacial surgery.
abstract: We have compared the anaesthetic efficacy, duration of action, pain, pulpal anaesthesia, and cardiovascular effects of 0.5% ropivacaine or 2% lignocaine hydrochloride in bilateral symmetrical impacted third molars. In a randomised single-blind trial we studied 78 healthy patients who required bilateral extraction of identical impacted lower third molars. A test dose was given to all patients with subdermal infiltration of 0.5% ropivacaine 0.5 ml. A classic inferior alveolar and long buccal nerve block was created using 0.5% ropivacaine 2 ml on one side and 2% lignocaine hydrochloride 2 ml with adrenaline on the other. The time to onset and duration of action were noted. Pain, numbness of the lip and tip of the tongue, and haemodynamic changes were monitored throughout the procedure. The teeth were extracted two weeks apart. The onset of anaesthesia ranged between 2 and 3 min after the injection and lasted for more than 5h. Ropivacaine alone did not cause appreciable changes in the cardiovascular variables, but lignocaine with adrenaline caused a transient increase in arterial pressure and heart rate 2 min after injection. We conclude the 0.5% ropivacaine alone does not affect the cardiovascular system and has more beneficial effects than 2% lignocaine hydrochloride with adrenaline. These findings may be useful for oral and maxillofacial surgeons who are looking for a local anaesthetic with minimal cardiovascular risk and without a vasoconstrictor to provide regional anaesthesia for long procedures.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, India. Electronic address: drabhishekbudharapu@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Budharapu
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, India.
authors.forename: R
authors.initials: R
authors.lastname: Sinha
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, India.
authors.forename: U K
authors.initials: UK
authors.lastname: Uppada
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, India.
authors.forename: A V S S
authors.initials: AV
authors.lastname: Subramanya Kumar
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D016063:Blood Loss, Surgical; D001794:Blood Pressure / Q000187:drug effects; D003782:Dental Pulp / Q000187:drug effects; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008046:Lip / Q000187:drug effects; D008297:Male; D008334:Mandible / Q000601:surgery; D008340:Mandibular Nerve / Q000187:drug effects; D008964:Molar, Third / Q000601:surgery*; D009407:Nerve Block / Q000379:methods; D061646:Operative Time; D010147:Pain Measurement / Q000379:methods; D000077212:Ropivacaine; D016037:Single-Blind Method; D013997:Time Factors; D014059:Tongue / Q000187:drug effects; D014081:Tooth Extraction / Q000379:methods*; D014095:Tooth, Impacted / Q000601:surgery*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D000077212:Ropivacaine; D008012:Lidocaine; D004837:Epinephrine
keywords: Adrenaline; Lignocaine HCl; Ropivacaine; Vasoconstrictor