Efficacy and safety of 1% ropivacaine for postoperative analgesia after lower third molar surgery: a prospective, randomized, double-blinded clinical study.
OBJECTIVE
The purpose of this study was to investigate postoperative analgesic effect of ropivacaine administered as main or supplemental injection for the inferior alveolar nerve block (IANB) in patients undergoing lower third molar surgery.


METHODS
The double-blind randomized study comprised 72 healthy patients. All patients received two blocks, the IANB for surgical procedure + IANB after surgery for postoperative pain control, and were divided into three groups: (1) 2 % lidocaine/epinephrine + 1 % ropivacaine, (2) 2 % lidocaine/epinephrine + saline, and (3) 1 % ropivacaine + saline. The occurrence of postoperative pain, pain intensity and analgesic requirements were recorded. Data were statistically analyzed using chi-square, Fisher, and Kruskal-Wallis tests and analysis of variance (ANOVA) with Bonferroni and Tukey correction.


RESULTS
Ropivacaine was more successful than lidocaine/epinephrine in obtaining duration of postoperative analgesia, reduction of pain, and analgesic requirements whether ropivacaine was used for surgical block or administered as a supplemental injection after surgery.


CONCLUSIONS
Ropivacaine (1 %, 2 ml) resulted in effective postoperative analgesia after lower third molar surgery.


CONCLUSIONS
Since pain control related to third molar surgery requires the effective surgical anesthesia and postoperative analgesia, the use of 1 % ropivacaine could be clinically relevant in a selection of appropriate pain control regimen for both surgical procedure and early postsurgical treatment.
Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade, 4 Dr Subotica Street, Belgrade, Serbia. brkovic73@yahoo.com.
Božidar
B
Brković
Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade, 4 Dr Subotica Street, Belgrade, Serbia.
Miroslav
M
Andrić
Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade, 4 Dr Subotica Street, Belgrade, Serbia.
Dejan
D
Ćalasan
Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade, 4 Dr Subotica Street, Belgrade, Serbia.
Marija
M
Milić
Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade, 4 Dr Subotica Street, Belgrade, Serbia.
Jelena
J
Stepić
Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade, 4 Dr Subotica Street, Belgrade, Serbia.
Milan
M
Vučetić
Division of Maxillofacial Surgery, Faculty of Medical Science, University of Kragujevac, Kragujevac, Serbia.
Denis
D
Brajković
Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade, 4 Dr Subotica Street, Belgrade, Serbia.
Ljubomir
L
Todorović
D000293:Adolescent; D000328:Adult; D000577:Amides / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D004311:Double-Blind Method; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008334:Mandible; D008964:Molar, Third / Q000601:surgery*; D009407:Nerve Block / Q000379:methods; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D000077212:Ropivacaine; D016896:Treatment Outcome
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D008012:Lidocaine; D004837:Epinephrine
Impacted lower third molar surgery; Inferior alveolar nerve block; Postoperative analgesia; Ropivacaine