Biotechnologie et biomatériaux

Abstrait

Ropivacaine versus Bupivacaine in Postoperative Pain Control

Noha Ahmed Mansour, Fouad A-Mahdy AL-Belasy, Mohamed Abdel-Monem Tawfik and Hamdy A Marzook

Objective: The aim of this study was to compare between 2 types of long acting anesthetics: bupivacaine 0.5% and ropivacaine 0.75%, in terms of their duration of anesthesia, duration of analgesia and their effect in controlling postoperative pain after surgical removal of impacted lower third molars. Material and Methods: This study was conducted on fifty subjects referred to the Oral Surgery Department, Faculty of Dentistry, Mansoura University, for surgical removal of impacted lower third molar. Subjects were randomly assigned prior to surgery into 2 nerve block injections; the first group (group A) for an inferior alveolar nerve block (IANB) using bupivacaine and the second group (group B) for an IANB using ropivacaine. In each group, the patient’s age, sex, type of impaction, severity of impaction was recorded. Time from the start of surgery till removal of impacted molar was taken as duration of surgery. Patients were instructed not to take any analgesics until numbness of lip and tongue receded.The time from onset of anaesthesia to when numbness of the lip and tongue receded as assessed by pricking is taken as the duration of anaesthesia. The time from the start of numbness to when the subject first requested a dose of oral analgesic (NSAID) was taken as duration of analgesia. Pain was assessed preoperatively and postoperatively, then patients instructed to record the extent of their pain at 3, 6, 9, and 12 hours on the day of surgery (D1), on the second (D2) and third days (D3) postoperatively. Post-operative analgesic consumption, inability to sleep because of pain, degree of overall satisfaction with the anaesthetic efficacy and postoperative pain management were considered. Results: The median duration of anaesthesia for the 7.5 mg/ml concentration of ropivacaine was approximately 6 hours, and for bupivacaine 5 mg/ml was approximately 7 hours. Bupivacaine can provide analgesia for 10.3 hours while ropivacaine can provide analgesia during the first 9.6 hours which is the period of maximum pain after third molar surgery. Conclusion: As regards a comparison of the study drugs with respect to post-operative pain experience, analgesic need and consumption, bupivacaine and ropivacaine appear to have equivalent efficacy.