Maxillary infiltration anaesthesia by ropivacaine for upper third molar surgery

Area of Science:

• Dentistry
• Pharmacology
• Anesthesiology

Background:

• Local anesthetics are crucial for dental procedures.
• Ropivacaine is a commonly used local anesthetic with a favorable safety profile.
• Assessing ropivacaine's efficacy and safety in third molar surgery is important for clinical practice.

Purpose of the Study:

• To evaluate the clinical effectiveness and hemodynamic impact of ropivacaine for infiltration anesthesia during upper third molar extractions.
• To assess the safety of ropivacaine by measuring plasma concentrations and arterial reactivity.

Main Methods:

• Dose-dependent assessment of ropivacaine (0.5%, 0.75%, 1%) for maxillary infiltration anesthesia.
• Monitoring of hemodynamic parameters during and after surgery.
• Measurement of maximal venous plasma concentration (Cmax) of ropivacaine.
• Evaluation of ropivacaine's effect on isolated human infraorbital arteries.

Main Results:

• Ropivacaine demonstrated dose-dependent anesthetic effects, with 0.75% and 1% being clinically relevant.
• Hemodynamic parameters remained stable during surgery, with changes noted 10 minutes postoperatively.
• The maximum venous plasma concentration (Cmax) after 2.0 ml of 1% ropivacaine was 82+/-15 microg/l.
• Ropivacaine induced endothelium-independent contraction in isolated human infraorbital arteries.

Conclusions:

• 0.75% and 1% ropivacaine provide adequate and safe intraoperative analgesia for third molar removal.
• Ropivacaine alone is insufficient for effective postoperative pain control in these procedures.
• Further research into multimodal pain management strategies is warranted.