Comparison of Efficacy of Lignocaine with Adrenaline and Bupivacaine without Adrenaline in Pain Management During Extraction of Mandibular Third Molars: A Prospective Study

Abstract

Background: Extraction of lower third molar is the most commonly performed surgery in oral and maxillofacial practice. Pain associated with this procedure is a frequent reason for patient anxiety and discomfort. A variety of anaesthetic agents are administered in order to provide intra operative pain relief.

Materials and methods: Participants were divided into 2 groups with 25 patients each. One group was administered 2% lignocaine hydrochloride with adrenaline 1:80,000 as local anaesthesia while the other group was administered 0.5% bupivacaine without adrenaline as anaesthesia. Intra operative and post operative pain scores were measured using Visual Analog Scale.

Results: While making statistical comparison between the two groups, a significant P value (p = 0.03) was observed, favouring the bupivacaine group for Intra operative pain relief. The p value obtained for post operative pain was also statistically significant (0.04) in favour of the bupivacaine group.

Conclusion: It was found that 0.5% bupivacaine without adrenaline was a better anaesthetic when compared to 2% lignocaine with 1:80,000 adrenaline for pain control during third molar extractions. This study demonstrated that bupivacaine, a long-acting amide anaesthetic provides better intraoperative and postoperative pain control during extractions of mandibular third molars and is especially significant in patients where adrenaline is contraindicated.