Topical bupivacaine for pain control following simple dental extractions

This study was carried out to examine the effectiveness of topically applied bupivacaine 0.25% with adrenaline 1:200,000, for post-operative analgesia in children undergoing dental extractions under general anaesthesia.

Randomised double blind study in a single centre.

An outpatient dental clinic in a district general hospital, in England, in 1997.

Subjects were selected from children of age 7-15 years having six or less extractions, and randomised using the closed envelope technique.

The local anaesthetic used was bupivacaine 0.25% with adrenaline 1:200,000.

Children were asked on waking from the anaesthetic whether they had pain or not. Pain was reassessed five and ten minutes post application of swabs to determine any changes in pain.

Forty-eight children were recruited, of these 18 had no pain post-operatively and 6 were withdrawn due to a lack of cooperation. Twelve children were randomised to each group. There were 6 boys and 6 girls in the bupivacaine group (age 7-15 years), and 4 boys and 8 girls in the saline group. Bupivacaine 0.25% with adrenaline soaked swabs resulted in a significant reduction in pain in 10 children at 10 minutes (P = 0.01).

Bupivacaine 0.25% with adrenaline 1:200,000, on application to exposed sockets is a simple technique that may provide useful post-operative analgesia.