4% Articaine and 2% Lignocaine for Surgical Removal of Third Molar by Mandibular Nerve Block: A Randomized Clinical Trial for Efficacy and Safety.

OBJECTIVE

Articaine entered clinical use in 1976; however, evidence basis for articaine's reputation is not entirely clear. The aim of the study is to compare and analyze 4% articaine with 1:100,000 epinephrine and 2% lignocaine with 1:100,000 epinephrine in patients operated for mandibular third molar impaction with respect to efficacy and safety, time of onset and duration of anesthesia and duration of postoperative analgesia.

METHODS

The study was done on fifty patients requiring surgical extraction of mandibular third molar; randomly divided into two groups of 25 each, receiving 4% articaine hydrochloride with 1:100,000 epinephrine and 2% lignocaine hydrochloride with 1:100,000 epinephrine. Difficulty index for extraction, volume, onset and duration of anesthesia and duration of postoperative analgesia were recorded. Pain was assessed using Heft-Parker VAS. The data were analyzed using appropriate statistical analysis.

RESULTS

The mean onset time for articaine and lignocaine is 3.16 ± 0.55 and 3.2 ± 0.48 min, respectively. Articaine group experienced statistically significant longer period of analgesia and duration of action 289.04 ± 40 and 361.88 ± 40 min, respectively, as compared to lignocaine which is 144.2 ± 12 and 197.44 ± 25 min, respectively. No statistical difference between the two groups with regard to pain experience.

CONCLUSION

4% Articaine is more potent and has longer duration of action with better postoperative analgesia and could be considered as an alternative to lignocaine in clinical practice. With management of postoperative pain being the critical component of patient care, clinical trials are required to develop long acting local anesthetic with increased postoperative analgesia effect.