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  • Title: Bupivacaine 0.5% versus articaine 4% for the removal of lower third molars. A crossover randomized controlled trial.
    Author: Sancho-Puchades M, Vílchez-Pérez MÁ, Valmaseda-Castellón E, Paredes-García J, Berini-Aytés L, Gay-Escoda C.
    Journal: Med Oral Patol Oral Cir Bucal; 2012 May 01; 17(3):e462-8. PubMed ID: 22143739.
    Abstract:
    OBJECTIVE: To compare the anesthetic action of 0.5% bupivacaine in relation to 4% articaine, both with 1:200,000 epinephrine, in the surgical removal of lower third molars. As a secondary objective hemodynamic changes using both anesthetics were analyzed. STUDY DESIGN: Triple-blind crossover randomized clinical trial. Eighteen patients underwent bilateral removal of impacted lower third molars using 0.5% bupivacaine or 4% articaine in two different appointments. Preoperative, intraoperative and postoperative variables were recorded. Differences were assessed with McNemar tests and repeated measures ANOVA tests. RESULTS: Both solutions exhibited similar latency times and intraoperative efficacy. Statistical significant lower pain levels were observed with bupivacaine between the fifth (p=0.011) and the ninth (p=0.007) postoperative hours. Bupivacaine provided significantly longer lasting soft tissue anesthesia (p<0.5). Systolic blood pressure and heart rate values were significantly higher with articaine. CONCLUSIONS: Bupivacaine could be a valid alternative to articaine especially due to its early postoperative pain prevention ability.
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