The Assessment of Prolonged Inferior Alveolar Nerve Blockade for Postoperative Analgesia in Mandibular Third Molar Surgery by a Perineural Addition of Dexamethasone to 0.5% Ropivacaine: A Randomized Comparison Study

Abstract

Background: Perineurally adding dexamethasone to local anesthetics could enable postoperative analgesia. Our aim was to investigate the efficacy of 4 mg dexamethasone and 0.5% ropivacaine on the prolonged duration of mandibular anesthesia for postoperative analgesia during third molar surgery. Materials and method: The patients of both sexes, and in the age range of 17 to 50 yrs of age, received the Gow-Gates anesthesia. Group I received 4 mL of plain 0.5% ropivacaine, with perineurally added 1 mL/4 mg of dexamethasone; group II received 4 mL of plain 0.5% ropivacaine with perineurally added 1 mL of 0.9% saline; group III received 4 mL of plain 0.5 bupivacaine with perineurally added 1 mL of 0.9% saline. The prime anesthesia outcome was the duration of conduction anesthesia (DCA); the secondary outcome was the duration of analgesia (DAN) and analgesia before analgesic intake. Results: In 45 randomly selected subjects (mean age 27.06 ± 8.20), DCA was statistically longest in group I (n = 15) (592.50 ± 161.75 min, p = 0.001), collated with groups II (n = 15) and III (n = 15) (307.40 ± 84.71 and 367.07 ± 170.52 min, respectively). DAN was significantly the longest in group I (mean: 654.9 ± 198.4 min, p = 0.001), compared with group II (345.4 ± 88.0 min) and group III (413.7 ± 152.3 min), with insignificant adverse reactions. One-third of the operated patients absented from the use of analgesics. Conclusion: A amount 0.5% ropivacaine with dexamethasone usefully served as an analgesic with a success rate of 93.4% of the given anesthesia.

The performance of inferior alveolar nerve block technique among undergraduate students

“…The success rate of IANB was 96.1% in the current study. According to previous studies, IANB had a success rates ranging from 71.5% to 100% 1,5,13,17–21,25,26 . It has been shown that intern trainers achieve a 97.6% success rate.…”

“…Previous studies found that positive aspirations of IANB ranged from 0% to 46.4% 9,12–20 . Several factors may explain this wide range, including the skills of the operator, the types of dental syringes and the gauge of the needle used in different studies.…”

“…Positive aspiration rates differ according to injection techniques and locations 13 . Previous studies found that the positive aspiration rate during IANB varied between 0% and 46.4% 9,12–20 …”

“…13 Previous studies found that the positive aspiration rate during IANB varied between 0% and 46.4%. 9,[12][13][14][15][16][17][18][19][20] It is essential for dental students to be able to achieve deep anaesthesia through a successful technique in order to take on confident dental treatment. Hence, validation of students' performance in local anaesthetic techniques is crucial.…”

Anatomic feasibility of a modified 3-distal site anesthesia injection method for impacted mandibular third molar extraction using cone-beam computed tomography

“…In recent years, a variety of injection methods have been described in the literature, all of which intended to improve the success rate of IAN block and avoid complications, although all have advantages and disadvantages (8,9). Gow-Gates mandibular nerve conduction anesthesia is reported to have a success rate up to 93% in a recent report (10). But this method has a long onset and a vague injection site location that is difficult to determine (7,11).…”