High volume local anesthesia as a postoperative factor of pain and swelling in dental implants

To determine whether the administration of high-volume local anesthesia can influence postoperative pain and swelling, and the degree of patient satisfaction, following dental implant placement.

One hundred patients (45 women and 55 men) between 19 and 80 years old were divided into two groups: group A (n = 50, with placement of an implant using an atraumatic approach in each patient, with sub-periosteal injection of a volume of Ultracain(®) ≤0.9 mL [half a carpule]) and group B (n = 50, involving the same surgical procedure but infiltrating a local anesthetic volume of ≥7.2 mL [four carpules]). Visual analog scales were used in all patients to rate intraoperative pain and postoperative pain and swelling. After the first week, the patients completed a questionnaire evaluating satisfaction with treatment.

The intraoperative pain scores were similar in both groups (p = 0.363), while the postoperative pain and swelling scores were significantly lower in group A at all time points. Patient rated satisfaction with the surgical treatment was higher in group A.

Excess injected volume of local anesthetic in dental implant surgery has a negative impact upon both postoperative pain and swelling, and on patient rated satisfaction.