Abstract
INTRODUCTION: The aim of this study was to compare the anesthetic efficacy of 4% articaine, 0.5% bupivacaine and 0.5% ropivacaine (with 1:200,000 adrenaline) during surgical removal of impacted mandibular third molars. MATERIALS AND METHODS: The study included 75 patients randomly divided into three equal groups of 25 patients each. The study variables were: onset of anesthetic action, duration of surgery and anesthesia and postoperative analgesia. A visual analog scale was used to assess pain at different time intervals. Statistical analysis revealed insignificant difference among groups in terms of volume of anesthetic solution used, quality of anesthesia, surgical difficulty and duration of surgery. RESULTS: The mean onset time was significantly (P < 0.001) shorter for articaine (1.14 min) than ropivacaine (2.18 min) and bupivacaine (2.33 min). However, the duration of anesthesia as well as analgesia was significantly (P < 0.001) longer for bupivacaine (483.6 min and 464 min) and ropivacaine (426.6 min and 459 min) as compared to articaine (232.8 min and 191.4 min), respectively. Also, on comparing three groups pain scores at 6th postoperative hour were significant (P < 0.01). CONCLUSION: Ropivacaine and bupivacaine can be safely used in patients where longer duration of surgery is anticipated.