ABSTRACT
OBJECTIVE: The aim of this study was to compare the local anesthesia efficacy of ropivacaine 0.75% compared to lidocaine 2% with 1:100,000 epinephrine for postoperative analgesia following extraction of impacted mandibular third molars. STUDY DESIGN: In this randomized, double-blind crossover clinical trial, 30 participants underwent surgical removal of bilateral impacted mandibular third molars under local anesthesia using ropivacaine 0.75% or lidocaine 2% with 1:100,000 epinephrine. The pain was recorded on a visual analog scale at 4, 8, 12, 24, and 48 h postoperatively. The use of analgesics and the presence of adverse effects were recorded. RESULTS: The duration of soft tissue anesthesia in the ropivacaine group was significantly longer than that in the lidocaine group. The lidocaine group recorded significantly higher visual analog scale scores at all postoperative time intervals, except in the final 48-h period. Analgesic use was higher in the lidocaine group. Rescue medication was used by 2 patients in each group (6.7%). Significantly more postoperative bleeding was seen in the ropivacaine group. CONCLUSION: Ropivacaine 0.75% injection before the surgical procedure may be associated with preventive analgesia for extraction of impacted mandibular third molars.
Subject(s)
Analgesia , Molar, Third , Anesthesia, Local , Anesthetics, Local , Double-Blind Method , Humans , Lidocaine , Molar, Third/surgery , Pain, Postoperative/drug therapy , Pain, Postoperative/prevention & control , Ropivacaine , Tooth ExtractionABSTRACT
Introdução: Medo e ansiedade são comuns a pacientes que requerem tratamento odontológico e, em se tratando de procedimentos cirúrgicos, a ansiedade pode tornar-se um fator complicador, a partir do momento em que a alteração dos sinais vitais do paciente pode gerar situações de emergência. Objetivo: Avaliar o grau de ansiedade pré-operatória dos pacientes submetidos a cirurgias orais, identificando qual procedimento cirúrgico causa mais ansiedade nos pacientes e qual o momento cirúrgico causador de maior ansiedade. Material e Método: Foram selecionados 200 pacientes que iriam se submeter a cirurgias bucais nos ambulatórios do Departamento de Odontologia da Universidade Federal de Sergipe. No dia da cirurgia, os pacientes respondiam à escala EAD, tendo sido avaliadas a frequência cardíaca (FC) e a pressão arterial sanguínea (PA), considerados dados basais dos parâmetros físicos empregados para a avaliação da ansiedade pré-operatória. Resultado: Não houve diferenças estatisticamente significantes (Kruskal-Wallis, p=0,6933) entre os tratamentos em relação à ansiedade. A correlação de Spearman (rS) entre os valores obtidos para a ansiedade e os valores de pressão arterial e frequência cardíaca revelou-se fraca (rS<0,2), embora significativa (p<0,05) entre os resultados. A anestesia foi o momento que produziu maior ansiedade (Kruskal-Wallis, p<0,05), em relação aos demais momentos. Conclusão: A ansiedade teve influência no aumento da frequência cardíaca e da pressão arterial sistólica, tornando-se importante o seu controle pelo cirurgião-dentista para evitar complicações no decorrer da cirurgia.
Introduction: Fear and anxiety are common in patients who require odontological treatment. During surgical procedures, anxiety can become a complicating factor from the moment in which the change of patients vital signs can generate emergency situations. Objective: Evaluate the degree of preoperative anxiety of patients submitted to oral surgery, to identify which surgical procedure causes more anxiety in patients and also which surgical moment is causing greater anxiety. Material and Method: 200 patients were selected for oral surgery at the clinics of the Department of Dentistry, Federal University of Sergipe. On the day of surgery, patients answered the EAD scale and their heart rate (HR) and blood pressure (BP) were evaluated. These data served as baseline of the physical parameters used in the evaluation of preoperative anxiety. Result: Statistically, there were no significant differences (Kruskal-Wallis test, p=0.6933) between treatments regarding anxiety. The Spearman correlation (rS) between the values obtained for anxiety, blood pressure levels and heart rate showed a weak correlation (rs <0.2), although significant (p<0.05) between the results. The anesthesia was the moment that produced greater anxiety (Kruskal-Wallis test, p<0.05) compared to the other moments. Conclusion: Anxiety has a connection with the increase of the heart rate and systolic blood pressure. This fact makes very important its control by the surgeon-dentist meaning to avoid complications through the surgery.