Tirumalasetty Shanmukha Srinivas Manikanta, Chinniswami Doraisami Dwarakanath, Konathala Santosh Venkata Ramesh, Penmetsa Subhadra Gautami, Gottumukkala Naga Venkata Satya Sai Sruthima
Department of Periodontics, GSL Dental College, Rajahmundry, India.
Department of Periodontics, Vishnu Dental College, Bhimavaram,India.
Eur Oral Res. 2021 Sep 1;55(3):139-145. doi: 10.26650/eor.2021853507.
To evaluate the effectiveness of bupivacaine and lidocaine local anesthesia on the intra-surgical and post-surgical pain control in patients undergoing periodontal flap surgery.
A randomized, single-blind, split-mouth design was employed in patients who are scheduled for periodontal flap surgery for at least two similar sextants with similar anesthetic techniques. Fifty patients (age range 16-65 years, 32 males and 28 females) enrolled in the present study. On one-site, the flap surgery was performed using 2% lidocaine with 1:200000 epinephrine and on the other with 0.5% bupivacaine with 1:200000 epinephrine. Base line clinical parameters, probing pocket depth, clinical attachment level were recorded. Pain during intra operative period, at the time of loss of numbness and for three consecutive days was measured using visual analog scale (VAS).
Significant differences were observed between the two groups in the intra operative pain scores (p=0.0045) and pain scores at the time of loss of numbness (p=0.0005) but not at the 1st, 2nd and 3rd day after the surgery.
Bupivacaine was markedy more effective than the lidocaine. Thus the usage of bupivacaine can be substantiated for periodontal surgeries for the control of pain in the intra operative and immediate post-operative period to increase patients' comfort.
评估布比卡因和利多卡因局部麻醉对接受牙周翻瓣手术患者术中及术后疼痛控制的效果。
采用随机、单盲、双侧对照设计，纳入计划接受牙周翻瓣手术且至少有两个相似象限采用相似麻醉技术的患者。本研究共纳入50例患者（年龄范围16 - 65岁，男性32例，女性28例）。在一侧，翻瓣手术使用含1:200000肾上腺素的2%利多卡因进行，另一侧使用含1:200000肾上腺素的0.5%布比卡因进行。记录基线临床参数，包括探诊深度、临床附着水平。使用视觉模拟量表（VAS）测量术中、麻醉消退时及术后连续三天的疼痛情况。
两组在术中疼痛评分（p = 0.0045）和麻醉消退时的疼痛评分（p = 0.0005）存在显著差异，但在术后第1、2和3天无显著差异。
布比卡因在控制疼痛方面明显比利多卡因更有效。因此，布比卡因在牙周手术中用于控制术中及术后即刻疼痛以提高患者舒适度是有依据的。
