Comparative Analysis of the Anesthetic Efficacy of 0.5% Ropivacaine Versus 2% Lignocaine Hydrochloride with Adrenaline (1:80,000) for Inferior Alveolar Nerve Block in Surgical Removal of Impacted Mandibular Third Molars.

Objective: To compare the onset, duration and depth of anesthesia, postoperative pain, duration of analgesia and adverse reaction between 0.5% ropivacaine and 2% Lignocaine hydrochloride with adrenaline (1:80,000) in 40 patients having bilaterally impacted mandibular third molars.

Patients And Methods: A prospective, randomized, single blind study was carried out among 40 patients requiring surgical removal of bilaterally impacted mandibular third molars having similar "difficulty index." The onset of action, duration and depth of anesthesia, duration of analgesia, postoperative pain and adverse reactions of 0.5% ropivacaine and 2% lignocaine hydrochloride with 1:80,000 adrenaline were evaluated. All patients were infiltrated intradermally with 0.5 ml of 0.5% ropivacaine as test dose to rule out any allergic reaction. The surgical extractions of the impacted third molars were done using the standard surgical procedure.

Results: 0.5% Ropivacaine had higher depth of anesthesia, longer duration of action and postoperative analgesic effect than 2% Lignocaine hydrochloride with 1:80,000 adrenaline with no adverse effects.

Conclusion: 0.5% ropivacaine is safe, efficacious, clinically acceptable and equally potent local anesthetic agent when compared to 2% lignocaine with 1:80,000 adrenaline in oral and maxillofacial surgery for longer duration of surgeries.