Analgesic Efficacy of Bupivacaine as an Infiltration Injection Technique after Extraction of Impacted Mandibular Third Molars: A Randomized Controlled Study

Abstract

Background: Pain after surgery is a common adverse effect that patients experience after having their lower third molars surgically removed. Objective: To assess how well local injection of bupivacaine reduces pain after surgical extraction of an impacted mandibular third molar. Methods: A single-blinded, randomized, controlled clinical trial included a total of 56 patients that were randomly selected according to Microsoft Office Excel sheets and divided into two groups. The study includes 29 patients who received a 2 ml dose of bupivacaine 0.5% through local infiltration near the extraction site using an insulin syringe to avoid intravenous or intraneural infiltration. The other 27 patients who served as the control group received a 2 mL dose of normal saline using the same administration technique. Both groups underwent a surgical procedure to remove their impacted mandibular third molars while under the influence of local anesthesia. Pain was evaluated using a numeric rating scale (NRS) at 4, 8, 12, and 24 hours post-operatively. Results: The study group exhibited significantly lower pain scores compared to the control group at 4, 8, 12, and 24 hours following the surgical procedure (p=0.0001). Conclusions: There were no major problems associated with the local injection of bupivacaine; it lowers postoperative pain 4, 8, 12, and 24 hours after the surgical extraction of impacted mandibular third molars.