Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Clinical Oral Investigations
Published in: Clinical Oral Investigations 3/2017

01-04-2017 | Original Article

Efficacy and safety of 1% ropivacaine for postoperative analgesia after lower third molar surgery: a prospective, randomized, double-blinded clinical study

Authors: Božidar Brković, Miroslav Andrić, Dejan Ćalasan, Marija Milić, Jelena Stepić, Milan Vučetić, Denis Brajković, Ljubomir Todorović

Published in: Clinical Oral Investigations | Issue 3/2017

Login to get access

Abstract

Objectives

The purpose of this study was to investigate postoperative analgesic effect of ropivacaine administered as main or supplemental injection for the inferior alveolar nerve block (IANB) in patients undergoing lower third molar surgery.

Materials and Methods

The double-blind randomized study comprised 72 healthy patients. All patients received two blocks, the IANB for surgical procedure + IANB after surgery for postoperative pain control, and were divided into three groups: (1) 2 % lidocaine/epinephrine + 1 % ropivacaine, (2) 2 % lidocaine/epinephrine + saline, and (3) 1 % ropivacaine + saline. The occurrence of postoperative pain, pain intensity and analgesic requirements were recorded. Data were statistically analyzed using chi-square, Fisher, and Kruskal-Wallis tests and analysis of variance (ANOVA) with Bonferroni and Tukey correction.

Results

Ropivacaine was more successful than lidocaine/epinephrine in obtaining duration of postoperative analgesia, reduction of pain, and analgesic requirements whether ropivacaine was used for surgical block or administered as a supplemental injection after surgery.

Conclusions

Ropivacaine (1 %, 2 ml) resulted in effective postoperative analgesia after lower third molar surgery.

Clinical Relevance

Since pain control related to third molar surgery requires the effective surgical anesthesia and postoperative analgesia, the use of 1 % ropivacaine could be clinically relevant in a selection of appropriate pain control regimen for both surgical procedure and early postsurgical treatment.
Literature
1.
Fisher SE, Frame JW, Rout PGJ, McEntegart DJ (1988) Factors affecting the onset and severity of pain following the surgical removal of unilateral impacted mandibular third molar teeth. Br Dent J 164:351–354CrossRefPubMed
2.
Shapiro RD, Cohen BH (1992) Perioperative pain control. Oral Maxillofac Clin N Am 4:663–664
3.
Caruso JM, Brokaw WC, Blanton EE (1989) Bupivacaine and lidocaine compared for postoperative pain control. Gen Dent 37:148–151PubMed
4.
Chapman PJ (1988) A controlled comparison of effectiveness of bupivacaine for post-operative pain control. Aust Dent J 33:288–290CrossRefPubMed
5.
6.
Junca A, Marret E, Goursot G, Mazoit X, Bonnet F (2001) A Comparison of ropivacaine and bupivacaine for cervical plexus block. Anesth Analg 92:720–724CrossRefPubMed
7.
Beilin Y, Galea M, Zahn J, Bodian CA (1999) Epidural ropivacaine for the initiation of labor epidural analgesia: a dose finding study. Anesth Analg 88:1340–1345CrossRefPubMed
8.
McClellen KJ, Faulds D (2000) Ropivacaine: an update of its use in regional anaesthesia. Drugs 60:1065–1073CrossRef
9.
Whiteside JB, Wildsmith JAW (2001) Developments in local anaesthesia drugs. Br J Anaesth 87:27–35CrossRefPubMed
10.
Klein SM, Greengrass RA, Steele SM, D’Ercole FJ, Speer KP, Gleason DH, DeLong ER, Warner DS (1998) A Comparison of 0.5% bupivacaine, 0.5% ropivacaine, and 0.75% ropivacaine for interscalene brachial plexus blocks. Anesth Analg 87:1316–1319PubMed
11.
Hickey R, Hoffman J, Ramamurthy S (1991) A comparison of ropivacaine 0.5% and bupivacaine 0.5% for brachial plexus block. Anesthesiology 74:639–642CrossRefPubMed
12.
Fibla JJ, Molins L, Mier JM, Sierra A, Vidal G (2008) Comparative analysis of analgesic quality in the postoperative of thoracotomy: paravertebral block with bupivacaine 0.5% vs ropivacaine 0.2%. Eur J Cardiothorac Surg 33:430–434CrossRefPubMed
13.
Anantanarayanan P, Raja DK, Kumar JN, Sneha P, Christabel A, Manikandhan R, Elavazhagan N (2013) Catheter-based donor site analgesia after rib grafting: a prospective, randomized, double-blinded clinical trial comparing ropivacaine and bupivacaine. J Oral Maxillofac Surg 71:29–34CrossRefPubMed
14.
Korula S, Grace Maria G, Shaloo I, Saramma AP (2011) Epidural anesthesia and post-operative analgesia for bilateral inguinal mesh hernioplasty: comparison of equipotent doses of ropivacaine and bupivacaine. Saudi J Anaesth 5:277–281CrossRefPubMedPubMedCentral
15.
Sanders RD, Mallory S, Lucas DN, Chan T, Yeo S, Yentis SM (2004) Extending low-dose epidural analgesia for emergency Caesarean section using ropivacaine 0.75%. Anaesthesia 59:988–992CrossRefPubMed
16.
Ernberg M, Kopp S (2002) Ropivacaine for dental anesthesia: a dose-finding study. J Oral Maxillofac Surg 60:1004–1010CrossRefPubMed
17.
Kennedy M, Reader A, Beck M, Weaver J (2001) Anesthetic efficacy of ropivacaine in maxillary anterior infiltration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 91:406–412CrossRefPubMed
18.
Meechan JG (2002) A comparison of ropivacaine and lidocaine with epinephrine for intraligamentary anesthesia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 93:469–473CrossRefPubMed
19.
Axelsson S, Isacsson G (2004) The efficacy of ropivacaine as a dental local anaesthetic. Swed Dent J 28:85–91PubMed
20.
Krzeminski TF, Gilowski L, Wiench R, Plocica I, Kondzielnik P, Sielanczyk A (2011) Comparison of ropivacaine and articaine with epinephrine for infiltration anaesthesia in dentistry—a randomized study. Int Endod J 44:746–751CrossRefPubMed
21.
Buric N (2006) The assessment of anesthetic efficacy of ropivacaine in oral surgery. N Y State Dent J 72:36–39PubMed
22.
23.
Brkovic BMB, Zlatkovic M, Jovanovic D, Stojic D (2010) Maxillary infiltration anaesthesia by ropivacaine for upper third molar surgery. Int J Oral Maxillofac Surg 39:36–41CrossRefPubMed
24.
Budharapu A, Sinha R, Uppada UK, Subramanya Kumar AVSS (2015) Ropivacaine: a new local anaesthetic agent in maxillofacial surgery. Br J Oral Maxillofac Surg 53:451–454CrossRefPubMed
25.
Malamed SF (2004) Local anesthetic considerations in dental specialties. In: Malamed SF (ed) Handbook of local anesthesia, 5th edn. Mosby, St. Louis, p 277
26.
Danielsson K, Evers H, Nordenram A (1985) Long-acting local anesthetics in oral surgery: an experimental evaluation of bupivacaine and etidocaine for oral infiltration anesthesia. Anesth Prog 32:65–68PubMedPubMedCentral
27.
Brajkovic D, Brkovic B, Milic M, Biocanin V, Krsljak E, Stojic D (2014) Levobupivacaine vs. bupivacaine for third molar surgery: quality of anaesthesia, postoperative analgesia and local vascular effects. Clin Oral Investig 18:1481–1488. doi:10.​1007/​s00784-013-1114-0 CrossRefPubMed
28.
Casati A, Fanelli G, Aldegheri G, Berti M, Colnaghi E, Cedrati V, Torri G (1999) Interscalene brachial plexus anaesthesia with 0.5%, 0.75% or 1% ropivacaine. a double blind comparison with 2% mepivacaine. Br J Anaesth 83:872–875CrossRefPubMed
29.
Coghlan JA, Forbes A, McKenzi D, Bell SN, Buchbinder R (2009) Efficacy of subacromial ropivacaine infusion for rotator cuff surgery. J Bone Joint Surg Am 91:1558–1567CrossRefPubMed
30.
Coban YK, Senoglu N, Oksuz H (2008) Effect of preoperative local ropivacaine infiltration on postoperative pain scores in infants and small children undergoing elective cleft palate repair. J Craniofac Surg 19:1221–1224CrossRefPubMed
31.
32.
33.
Kimi H, Yamashiro M, Hashimoto S (2012) The local pharmacokinetics of 3H-ropivacaine and 14C-lidocaine after maxillary infiltration anesthesia in rats. Anesth Prog 59:75–81CrossRefPubMedPubMedCentral
34.
Crincoli V, Di Bisceglie MB, Massaro M, Giuliano R, Favia G, Brienza N (2009) Postoperative pain relief after surgical removal of impacted third molars: a single-blind, randomized, controlled study to compare levobupivacaine and mepivacaine. J Orofac Pain 23:325–329PubMed
35.
Rood JP, Snowdon AT, Gennery BA (2002) Safety and efficacy of levobupivacaine for postoperative pain relief after surgical removal of impacted third molars: a comparison with lignocaine and adrenaline. Br J Oral Maxillofac Surg 40:491–496. doi:10.​1016/​S0266-4356(02)00184-5 CrossRefPubMed
36.
Cline E, Franz D, Polley RD, Moye J, Burkard J, Pellegrini J (2004) Analgesia and effectiveness of levobupivacaine compared with ropivacaine in patients undergoing an axillary brachial plexus block. AANA Jorunal 72:339–345
37.
Casati A, Jacques EC, Cerchierini E, Santorsola R, Nobili F, Grispigni C, Di Benedetto P, Torri G (2002) Clinical properties of levobupivacaine or racemic bupivacaine for sciatic nerve block. J Clin Anesth 14:111–114CrossRefPubMed
38.
Polley LS, Columb MO, Naughton NN, Wagner DS, van de Ven CJ (1999) Relative analgesic potencis of ropivacaine and bupivacaine for epidural analgesia in labour. Anesthesiology 90:944–950CrossRefPubMed
39.
Liisanantti O, Luukkonen J, Rosenberg PH (2004) High-dose bupivacaine, levobupivacaine and ropivacaine in axillary brachial plexus block. Acta Anaesthesiol Scand 48:601–606CrossRefPubMed
40.
Casati A, Borghi B, Fanelli G, Montone N, Rotini R, Fraschini G, Vinciguerra V, Torri G, Chelly J (2003) Intersclene brachial plexsus anesthesia and analgesia for open shoulder surgery: a randomized double-blinded comparison between levobupivacaine and ropivacaine. Anesth Analg 96:253–259PubMed
41.
Timponi CF, Oliveira NE, Arruda RMP, Meyrelles SS, Vasquez EC (2006) Effects of the local anaesthetic ropivacaine on vascular reactivity in the mouse perfused mesenteric arteries. Basic Clin Pharmacol Toxicol 98:518–520CrossRefPubMed
42.
Moffitt DL, de Berker DAR, Kennedy CTK, Shutt LE (2001) Assessment of ropivacaine as a local anesthetic for skin infiltration in skin surgery. Dermatol Surg 27:437–440PubMed
43.
Oliveira NE, Lima Filho NS, Lima EG, Vasquez EC (2006) Effects of regional anesthesia with ropvacaine on arterial pressure and heart rate in healithy subjects. Eur J Oral Sci 114:27–32CrossRefPubMed
Metadata
Title
Efficacy and safety of 1% ropivacaine for postoperative analgesia after lower third molar surgery: a prospective, randomized, double-blinded clinical study
Authors
Božidar Brković
Miroslav Andrić
Dejan Ćalasan
Marija Milić
Jelena Stepić
Milan Vučetić
Denis Brajković
Ljubomir Todorović
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 3/2017
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-016-1831-2

Other articles of this Issue 3/2017

Clinical Oral Investigations 3/2017 Go to the issue

Review

Is there enough evidence to use botulinum toxin injections for bruxism management? A systematic literature review

Original Article

Comparative evaluation of the retaining of QMix and chlorhexidine formulations on human dentin: a chemical analysis

Original Article

Ultrasonic activation of irrigants increases growth factor release from human dentine

Original Article

Effect of nasal high-flow oxygen therapy on the swallowing reflex: an in vivo volunteer study

Original Article

Gustatory function and taste perception in patients with oral lichen planus and tongue involvement

Original Article

Long-term effect of periodontal surgery on oral health and metabolic control of diabetics