Introduction. Ropivacaine is used in orthopedcs, gyneacology, surgery,
ophtamology, whereas experience about its usage in dentistry is still
limited. The aim of this research was to compare the anesthetic effect
between local anesthetics ropivacaine and bupivacaine, in surgical disposals
of chronical periapical lessions in maxilla. Material and methods. The study
included the patients that had indications for surgical removal of chronical
periapical lessions at one of the frontal teeth of upper jaw. The total total
number of examinees was 60, and they were devided in two groups. Ropivacaine
chloride (0.75%) was used as a local anesthetic in one group (Naropin? 0,75%;
Astra Zeneca), and in the other one bupivacaine chloride (0.5%) (Vexelit?
0,5%; Zdravlje). The autors applied 1,8 ml of block anesthesia for the n.
infraorbitalis (intraoral approach) as well as 0,2 ml of the local anesthetic
from the palatine side for the final branches of n. nasopalatinus in order to
observe the folloving anesthetic parameters. I. Beginning of anesthesia was
followed by the appearence of upper lip numbness. II. Pain rating scale
according to Sisk was used for the objective measurement of the anesthesia
quality. III. The pain intensity during the intervention was measured by
visual analogous scale, on which the patient denoted the intensity of pain he
had felt during the intervention. IV. Duration of anesthetic effect - it is
followed by soft tissues numbness. Results and discussion. After the
ropivacaine application anesthesia effect started in 1.57 min. and after the
usage of bupivacaine in 1.67 min. The mean duration of soft tissue numbness
after the application of ropivacaine was 321 minutes. Bupivacaine had a
shorter anesthetic effect - 296.5 minutes. The quality of anesthesia after
the usage of ropivacaine was assessed by the surgeons with average mark -
1.76. Interventions in which this anesthetic was used were performed with
minimal pain and without additional anesthesia. The quality of anesthesia
after the usage of bupivacaine (3.03) was statistically much worse (p<0.01)
in comparison to ropivacaine. In visual analogous scale where patients
denoted the intensity of pain during the intervention with ropivacaine the
marked average value was 30.1 mm while the average value with usage of
bupivacaine was 41.7 mm. The patients from the control group, where
bupivacaine was used, had much stronger pain, statistically significant
(p<0.05) in comparison to the group where ropivacaine was used. Our results
show that the quality of anesthesia that was attained with 0,5% bupivacaine
was much worse than the quality of anesthesia after the application of 0,75%
ropivacaine. Conclusion. Ropivacaine has a potential to replace bupivacaine
completely in cases when there is the indication for its usage in oral
surgery (longlasting intervention, interventions followed by intensive
postoperational pain, nerve blockade).
Evaluation of anesthetic effect of ropivacaine in surgery of chronic periapical lessions
