The Comparative Evaluation of the Anesthetic Efficacy of 4% Articaine With 1:100,000 Adrenaline and 0.75% Ropivacaine for Inferior Alveolar Nerve Block in the Extraction of Impacted Lower Third Molar

Introduction Postoperative pain management is a major concern in lower third molar surgery. Various local anesthetic agents are studied for the same. Articaine and ropivacaine are recently studied for pain control intra- and postoperatively in minor oral surgical procedure. However, there is sparse literature that compares these two agents. Therefore, the present study was designed to compare 4% articaine with 1:100,000 adrenaline and 0.75% ropivacaine for inferior alveolar nerve block in lower impacted third molar surgery. Materials and method A prospective, randomized controlled, split-mouth, double-blind study was performed. A total of 60 healthy patients requiring extraction of lower impacted third molar with similar difficulty index were included in the study. Patients were administered 4% articaine with 1:100,000 adrenaline and 0.75% ropivacaine on either side by random allocation. The procedure was performed at an interval of 14 days. Parameters assessed were time of onset of anesthesia, profoundness of anesthesia, hemodynamic parameters (heart rate and blood pressure), duration of soft tissue anesthesia, duration of postoperative analgesia, and postoperative symptom severity (PoSSe) scale. Results The time of onset of articaine was faster (69.20 + 20.13 seconds) compared to ropivacaine (104.06 + 17.66 seconds). No significant difference was observed in hemodynamic parameters. There was significant difference in duration of soft tissue anesthesia, postoperative analgesia, and PoSSe scale between the two groups. Conclusion Within the limitations of the study, 0.75% ropivacaine was effective in providing prolonged soft tissue anesthesia, postoperative analgesia, and better PoSSe scale with hemodynamic stability compared to 4% articaine.