A Prospective, Randomized, Double-Blind Comparison of Bupivacaine and Lidocaine for Inferior Alveolar Nerve Blocks

Abstract

The purpose of this prospective, randomized, double-blind study was to compare the degree of pulpal anesthesia obtained with 0.5% bupivacaine with 1:200,000 epinephrine and 2% lidocaine with 1:100,000 epinephrine in inferior alveolar nerve blocks. Using a crossover design, inferior alveolar nerve blocks were randomly administered, in a double-blind manner, using 0.5% bupivacaine with 1:200,000 epinephrine and 2% lidocaine with 1:100,000 epinephrine, at two separate appointments, to 39 subjects. A pulp tester was used to test for anesthesia until two consecutive readings of less than 80 were recorded on at least three of the five experimental teeth. Anesthesia was considered successful when two consecutive 80 readings were obtained within 15 min and the 80 reading was continuously sustained for 60 min. Anesthetic success was significantly improved for all teeth except the first molar with the lidocaine solution. Pulpal anesthesia averaged 4 hr for bupivacaine versus 2 hr and 24 min for lidocaine.

Comparative study of two local anesthetics in the surgical extraction of mandibular third molars: Bupivacaine and articaine

“…In the study by Gregorio et al (14), reinforcement was necessary in 14% of surgeries performed with bupivacaine and 2% of those performed with articaine, this difference was significant. It has been shown that bupivacaine is less effective in infiltrative techniques, due to its high lipid solubility which also makes the position of the needle key (4,6,11). This could explain the difference found in the work by Gregorio et al (14).…”

“…Because of its diverse pathology, third molar extraction is one of the most common surgical procedures in oral surgery, and is generally accompanied by postoperative discomfort, leading to the intake of analgesics, anti-inflammatories and antibiotics, and sometimes absenteeism from work. It has been suggested that the longer duration of action of bupivacaine associated with the residual analgesia and the gradual onset of pain, may reduce the need for analgesics, which could be interesting given the side effects that these are associated with (3)(4)(5)(11)(12)(13). This study aims to compare the efficacy and safety of bupivacaine and articaine as local anesthetics for the extraction of mandibular third molars, and verify whether bupivacaine produced residual analgesia.…”

Evaluation of Post-Operative Pain After Irrigation Using End-Vented Navitip Tips Versus Side-Vented Navitip Tips in Teeth With Irreversible Pulpitis: A Randomized Clinical Trial Part Vi.

“…The results of this study showed an observable increase in pain levels at 4-hrs in both groups compared to the immediate post-operative pain levels, this may be related to the loss of local anesthetic effect (27) . This was in agreement with the results of Gondim et al (2010) (8) and Al-Zaka (2012) (9) that showed that the highest levels of pain occurred at 0-4-hrs and then decreased at 24 and 48-hrs.…”

A Comparative Study Between Bupivacaine with Adrenaline and Carbonated Bupivacaine with Adrenaline for Surgical Removal of Impacted Mandibular Third Molar

“…Large number of studies were done to compare the efficacy of bupivacaine with other amide local anesthetics such as lidocaine. The anesthetic efficacy of bupivacaine hydrochloride was more compared to lidocaine hydrochloride and was effective in postoperative pain management [17]. Many studies reported that the combination of lidocaine hydrochloride with long acting local anesthetic will increase the duration of action and decrease patient discomfort [18].…”