Bupivacaine 0.5 % versus articaine 4 % for the removal of lower third molars. A crossover randomized controlled trial

Manuel Sancho-Puchades ^[1] ; Miguel A. Vílchez-Pérez ^[1] ; Eduard Valmaseda-Castellón ^[1] ; Jordi Paredes-García ^[1] ; Leonardo Berini-Aytés ^[1] ; Cosme Gay-Escoda ^[1]
1. [1] Universitat de Barcelona
  
  Universitat de Barcelona
  
  Barcelona, España
Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 17, Nº. 3 (Mayo), 2012
Idioma: inglés
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Resumen
- Objective: To compare the anesthetic action of 0.5% bupivacaine in relation to 4% articaine, both with 1:200,000 epinephrine, in the surgical removal of lower third molars. As a secondary objective hemodynamic changes using both anesthetics were analyzed.
  
  Study Design: Triple-blind crossover randomized clinical trial. Eighteen patients underwent bilateral removal of impacted lower third molars using 0.5% bupivacaine or 4% articaine in two different appointments. Preoperative, intraoperative and postoperative variables were recorded. Differences were assessed with McNemar tests and repeated measures ANOVA tests.
  
  Results: Both solutions exhibited similar latency times and intraoperative efficacy. Statistical significant lower pain levels were observed with bupivacaine between the fifth (p=0.011) and the ninth (p=0.007) postoperative hours. Bupivacaine provided significantly longer lasting soft tissue anesthesia (p<0.05). Systolic blood pressure and heart rate values were significantly higher with articaine.
  
  Conclusions: Bupivacaine could be a valid alternative to articaine especially due to its early postoperative pain prevention ability.