Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Baghdad, Baghdad Medical City, Bab-Almoadham, Baghdad, Iraq.
Dent Med Probl. 2021 Oct-Dec;58(4):483-488. doi: 10.17219/dmp/133664.
Postoperative pain is one of the main complications following impacted mandibular third molar (IMTM) surgery.
The aim of this study was to assess the effect of the local application of bupivacaine on reducing early postoperative pain following IMTM surgery.
A prospective, single-blinded, randomized controlled study was conducted on 40 patients who had undergone the surgical removal of an IMTM under local anesthesia. In the study group (n = 20), absorbable gelatin sponge (AGS) soaked in 3 mL of 0.5% plain bupivacaine hydrochloride was locally applied in the post-extraction socket. In the control group (n = 20), AGS soaked in 3 mL of normal saline was used. Pain intensity was assessed using a pain numerical rating scale (NRS) 4 and 12 h postoperatively. The variables were compared between the 2 groups and probability values <0.05 were considered statistically significant.
The pain scores in the study group were significantly lower than those recorded in the control group at 4 h postoperatively (p = 0.003), whereas the difference in the pain scores between the 2 groups 12 h after surgery was not statistically significant (p = 0.443).
The local application of bupivacaine is effective in reducing postoperative pain 4 h after the surgical extraction of IMTMs without any significant complications.
下颌阻生第三磨牙（IMTM）术后疼痛是主要并发症之一。
本研究旨在评估局部应用布比卡因对减少 IMTM 手术后早期疼痛的效果。
对 40 例行局部麻醉下 IMTM 切除术的患者进行前瞻性、单盲、随机对照研究。在研究组（n = 20）中，将 3 mL 0.5%布比卡因盐酸盐普通溶液浸泡的可吸收明胶海绵（AGS）局部应用于拔牙窝。在对照组（n = 20）中，使用 3 mL 生理盐水浸泡的 AGS。术后 4 小时和 12 小时使用疼痛数字评分量表（NRS）评估疼痛强度。比较两组之间的变量，概率值 <0.05 被认为具有统计学意义。
研究组的疼痛评分在术后 4 小时显著低于对照组（p = 0.003），而两组术后 12 小时的疼痛评分差异无统计学意义（p = 0.443）。
局部应用布比卡因可有效减轻 IMTM 术后 4 小时的术后疼痛，且无明显并发症。
