Efficacy of Levobupivacaine and Ropivacaine in Postoperative Pain control after Surgical Removal of Impacted Mandibular Third Molar: A Split Mouth Randomized Clinical Trial

Objectives: The aim of the present clinical trial study is to compare the efficacy of 0.75% levobupivacaine with that of 0.75% ropivacaine for pain control after surgical removal of impacted mandibular third molars.

Methods: This prospective study included 40 patients (30 females and 10 males) who had been referred to the Department of Oral and Maxillofacial Surgery for surgical removal of third molars of similar difficulty index in two separate sessions under local anaesthesia. Within each patient, levobupivacaine was used to anesthetize one extraction side and for the other side, ropivacaine was used. Onset of anaesthesia, duration of surgery, timing of pain appearance and analgesic consumption were evaluated. Data collected was statistically analysed and results obtained.

Results: In this study we observed, there were no significant differences in onset of anaesthesia and duration of surgical procedure between the two groups (P> 0.05). Timing of pain appearance and of first drug consumption was earlier in the ropivacaine group than levobupivacaine group and the results were statistically significant (P< 0.05). Patients with levobupivacaine anaesthesia had significantly lower visual analogue (VAS) pain scores at 1 and 2 hours postoperatively than those with ropivacaine anaesthesia.

Conclusion: Within the limitations of the present study, Levobupivacaine is a valid alternative to traditional local anaesthetics for surgical removal of lower third molars. It presents better pain relief when compared to ropivacaine in the immediate postoperative period as evidenced by lower VAS scores.