@article{
author = "Brajković, Denis and Biočanin, Vladimir and Milić, Marija and Vučetić, Milan and Petrović, Renata and Brković, Božidar",
year = "2015",
abstract = "Background/Aim. Surgical extraction of lower third molars is followed by mild or severe postoperative pain which peaks at maximal intensity in the first 12 hours and has a significant impact on a patient's postoperative quality of life. The use of long-acting local anaesthetics is a promising strategy to improve postoperative analgesia. The aim of the present study was to investigate analgesic parameters and patient satisfaction after using 0.5% levobupivacaine (Lbup), 0.5% bupivacaine (Bup) and 2% lidocaine with epinephrine 1:80,000 (Lid + Epi) for an inferior alveolar nerve block following lower third molar surgery. Methods. A total of 102 patients (ASA I) were divided into three groups, each of which received either 3 mL of Lbup, Bup or Lid + Epi. The intensity of postoperative analgesia was measured using a verbal rating scale (VRS). The total amounts of rescue analgesics were recorded on the first and during seven postoperative days. Patients satisfaction was noted using a modified verbal scales. Results. A significantly higher level of postoperative pain was recorded in Lid + Epi group compared to Bup and Lbup groups. No significant differences were seen between Bup and Lbup, but a significant reduction in the need for rescue analgesics was seen postoperatively in both Lbup and Bup (50%) in comparison with Lid + Epi (80%) in the first 24 hours. The same significant trend in rescue analgesic consumption was recorded for seven postoperative days. Patients' overall satisfaction was significantly lower for Lid + Epi (10%) than for Lbup (56%) and Bup (52%). Conclusion. The use of a new and long-acting local anaesthetic 0.5% levobupivacaine is clinically relevant and effective for an inferior alveolar nerve block and postoperative pain control after third molar surgery. In our study Lbup and Bup controlled postoperative pain more efficiently after lower third molar surgery compared to Lid + Epi., Uvod/Cilj. Hirurško vađenje donjih impaktiranih umnjaka praćeno je bolom umerenog do jakog intenziteta, sa maksimalnim intenzitetom tokom prvih 12 sati, koji ima značajan uticaj na kvalitet života pacijenata u postoperativnom periodu. Upotreba dugodelujućih lokalnih anestetika predstavlja obećavajuću strategiju za poboljšanje postoperativne analgezije. Cilj ove studije bio je da se ispitaju analgeticki parametri i zadovoljstvo pacijenata postignutom analgezijom u postoperativnom periodu nakon primene 0,5% levobupivakaina (Lbup), 0,5% bupivakaina (Bup) i 2% lidokaina sa epinefrinom (1: 80,000) (Lid + Epi) za sprovodnu anesteziju donjeg alveolarnog nerva prilikom hirurškog vađenja donjih umnjaka. Metode. Ukupno 102 pacijenta (ASA I) bila su podeljena u tri grupe u zavisnosti od primljenog anestetika: 3 mL Lbup, 3 mL Bup ili 3 mL Lid + Epi. Intenzitet postoperativne analgezije registrovan je primenom verbalne rangirajuće skale (VRS). Zabeležena je ukupna količina primenjenih analgetika nakon prvog i sedmog postoperativnog dana. Zadovoljstvo pacijenata ocenjivano je na osnovu modifikovanih verbalnih skala. Rezultati. Značajno jači intenzitet postoperativnog bola zabeležen je u grupi Lid + Epi, u poređenju sa grupama Lbup i Bup. Značajno smanjenje potrebe za analgeticima u postoperativnom periodu zabeleženo u grupama Lbup i Bup (50%) u poređenju sa grupom Lid + Epi (80%) nakon 24 časa. Značajno smanjenje potrebe za postoperativnim analgeticima u grupama Lbup i Bup zabeleženo je i nakon 7 dana. Potpuno zadovoljstvo pacijenata postignutom analgezijom bilo je značajno slabije u grupi Lid + Epi (10%) u poređenju sa grupama Lbup (56%) i Bup (52%). Zaključak. Upotreba novog dugodelujućeg lokalnog anestetika 0,5% levobupivakaina klinički je relevantna i efikasna za sprovodnu anesteziju donjeg alveolarnog nerva i kontrolu postoperativnog bola nakon hirurškog vađenja donjih umnjaka. U našoj studiji Lbup i Bup bili su efikasniji u kontroli postoperativnog bola nakon hirurškog vađenja donjih umnjaka u poređenju sa Lid + Epi.",
publisher = "Vojnomedicinska akademija - Institut za naučne informacije, Beograd",
journal = "Vojnosanitetski pregled",
title = "Quality of analgesia after lower third molar surgery: A randomised, double-blind study of levobupivacaine, bupivacaine and lidocaine with epinephrine, Kvalitet analgezije nakon hirurškog vađenja donjih umnjaka - randomizovana, duplo slepa studija efikasnosti levobupivakaina, bupivakaina i lidokaina sa adrenalinom",
volume = "72",
number = "1",
pages = "50-56",
doi = "10.2298/VSP1501050B"
}
