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Twin Mixed Local Anesthesia in Third Molar Surgery - Randomized Controlled Trial.
Shivangi Gaur1, Madhulaxmi Marimuthu2, Abdul Wahab2
1Post graduate Resident, Department of Oral & Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai India.
Summary
Adding dexamethasone to bupivacaine or ropivacaine injections improved patient comfort during third molar extraction. The modified twin mixes reduced pain and swelling compared to standard local anesthetics.
Area of Science:
- Oral and Maxillofacial Surgery
- Anesthesiology
- Pharmacology
Background:
- Third molar extraction is a common surgical procedure.
- Effective pain and swelling management is crucial for patient recovery.
- Long-acting amide local anesthetics like bupivacaine and ropivacaine are frequently used.
Purpose of the Study:
- To compare the clinical efficacy of bupivacaine and ropivacaine, with and without dexamethasone, for third molar extraction.
- To evaluate the impact of dexamethasone on pain, swelling, and anesthesia duration.
Main Methods:
- A prospective randomized double-blind controlled trial involving 68 patients.
- Four groups received either bupivacaine or ropivacaine, with or without 4 mg dexamethasone.
- Pain (Visual Analog Scale), mouth opening, and facial swelling were assessed post-procedure.
Main Results:
- Experimental groups receiving dexamethasone showed significantly lower pain scores on injection.
- Dexamethasone groups experienced longer soft tissue anesthesia durations.
- Control groups (without dexamethasone) exhibited increased postoperative swelling, pain, and trismus.
Conclusions:
- Modified twin mixes of bupivacaine or ropivacaine with dexamethasone enhance intraoperative and postoperative comfort.
- Dexamethasone improves the clinical efficacy of local anesthetics for mandibular third molar extractions.
