Comparison of Efficacy of Articaine and Bupivacaine after Impacted Third Surgery: A Double-Blinded Randomized Controlled Trial
Author(s): Rezin Ahmed*, MR Muthusekhar and Senthil Murugan P
Abstract
Objective: This randomized controlled clinical trial(RCT) aims to compare the effect of bupivacaine and Articaine at normal doses on pain intensity and the requirement for analgesics after lower third molar extraction. Materials and methods: The final study sample comprised 50 volunteers (26 males and 24 females; age range, 18-30 years) undergoing scheduled surgical extraction of the impacted lower third molar. A computer-generated random sequence was used to allocate participants to the articaine (4%) or bupivacaine (0.5%) group. Surgeons and patients were blinded by labeling the articaine and bupivacaine carpules with numbers (1 and 2, respectively). Postoperative pain intensity (primary outcome) was evaluated with a visual analog scale (VAS), while the requirement for and timing of rescue medication and the quality of intraoperative anesthesia were also measured (secondary outcomes). Results: VAS-measured pain intensity was significantly higher (p < 0.05) in the articaine group than in the bupivacaine group at all-time points except for 8 h post-surgery (p=0.052). Rescue medication was required by 13 (52%) patients in the articaine group and 8 (32%) patients in the bupivacaine group, although the difference was not statistically significant (p=0.252). The groups did not significantly differ (p=0.391) in the quality of the intraoperative anesthesia. Conclusions: Bupivacaine is a valid alternative to articaine in third molar surgery and may offer residual anesthesia as a means of reducing postoperative pain. However, further well-designed RCTs are required in larger study populations to verify the effectiveness of bupivacaine to achieve residual analgesia after oral surgery.