Combination of Articaine and Ketamine V/S Articaine Alone After Surgical Extraction of Impacted Third Molars

OBJECTIVE: Local anesthetics are the most effective drugs available for the management of pain while performing operative procedures. This study was performed to compare the clinical efficacy of treatment with local anesthetic articaine (4%) with ketamine and local anesthetic articaine alone (4%) for the relief or prevention of postoperative pain, swelling, and trismus after the surgical extraction of impacted mesioangular third molars. MATERIALS AND METHODS: Sixty patients undergoing the extraction of impacted mesioangular mandibular third molars were included in the study. The patients were randomly divided into two groups: local anesthetic alone (LAA) and local anesthetic plus ketamine (LAK). RESULTS: Facial swelling following surgery on postoperative days was significantly lower in the LAK group than in the LAA group on 3(rd) and 7(th) postoperative days (P < 0.05). Mouth opening on the postoperative days was significantly greater in the LAK group than in the LAA group on 3(rd) and 7(th) postoperative days (P < 0.05). The pain scores on the visual analog scale at 30 min and 1 h, 4 h, 12 h, and 24 h after the surgery were significantly higher in the LAA group than in the LAK group and there was no significant difference in heart rate, oxygen saturation, and blood pressure in both the groups. CONCLUSION: In this present study, the effect of articaine with ketamine in comparison with articaine alone intraoperatively and postoperatively was observed, and it revealed that the combination of articaine with ketamine produced good local anesthesia and provide good postoperative analgesia with less swelling and significantly less trismus.