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Clinical Oral Investigations
Published in: Clinical Oral Investigations 11/2023

20-09-2023 | Local Anesthesia in Dentistry | Research

Efficacy of lidocaine vs combination of lidocaine and bupivacaine in management of maxillofacial trauma: a clinical comparative study

Authors: Daniel Maben, Amal Suresh, Anil Kumar Desai, Shavari Shetty, Uday Juturu, Jawahar Anand

Published in: Clinical Oral Investigations | Issue 11/2023

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Abstract

Background

The COVID-19 pandemic has created an unprecedented situation which the treatment of maxillofacial trauma, especially mandibular fractures that were previously managed using general anaesthesia had to be performed under local anaesthesia. In these cases, there was a requirement for an anaesthetic agent that would have a rapid onset but also provide a prolonged effect. The aim of the study was to evaluate the onset, duration, depth, required volume of anaesthesia of lidocaine with epinephrine versus combination of lidocaine and bupivacaine with epinephrine anaesthetic agents in surgical management of isolated mandibular fracture patients.

Methods

A total of 30 patients with isolated mandibular fractures reported to our hospital included the study group. Patients were randomly distributed to two groups, Group A and Group B. Group A received local anaesthesia using 2% Lidocaine with 1:80,000 adrenaline and Group B received 0.5% Bupivacaine with 1:2,00,000 adrenaline combined with 2% Lidocaine with 1:80,000 adrenaline at a ratio of 1:1. The outcome variables were recorded and the data was tabulated and analysed using un-paired students t test.

Results

The combination of anaesthetic agents had longer duration of action (mean: 182.47 min, P-value: 0.001) and required lesser volume of anaesthetic solutions (mean: 5.38 mL, P-value: 0.001) as compared to usage of lidocaine alone. Although combination group showed quicker onset (mean: 4 min 8 s), the result was insignificant (p-value: 0.345).

Conclusion

The study found that the combination of lidocaine and bupivacaine could serve as a potential anaesthetic cocktail in effective surgical management of isolated mandibular fractures.

Clinical relevance

Maxillofacial injuries can be managed efficiently under local anaesthesia using combination of lidocaine and bupivacaine.
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Metadata
Title
Efficacy of lidocaine vs combination of lidocaine and bupivacaine in management of maxillofacial trauma: a clinical comparative study
Authors
Daniel Maben
Amal Suresh
Anil Kumar Desai
Shavari Shetty
Uday Juturu
Jawahar Anand
Publication date
20-09-2023
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 11/2023
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-023-05267-w

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