Anesthetic Efficacy of Different Ropivacaine Concentrations for Inferior Alveolar Nerve Block

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Anesthetic Efficacy of Different Ropivacaine Concentrations for Inferior Alveolar Nerve Block
Anesthesia Progress
Volume 53, Issue 1 (Spring 2006)

Eman El-Sharrawy, MBBCh, MSc, MD*, John A. Yagiela, DDS, PhD‹
* Faculty of Dentistry, Tanta University, Cairo, Egypt
‹ Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, California

This study was conducted on 72 American Society of Anesthesiologists class 1 patients scheduled for extraction of a mandibular third molar after inferior alveolar nerve block. Each patient was randomly administered one of the following ropivacaine concentrations: 0.75%, 0.5%, 0.375%, or 0.25% (18 patients per group). Onset of block (mean ± SD) was rapid for both 0.75% (1.4 ± 0.4 minutes) and 0.5% (1.7 ± 0.5 minutes) ropivacaine but significantly slower for the 0.375% (4.2 ± 2.5 minutes) and 0.25% (10.7 ± 3.0 minutes) concentrations. Tooth extraction was performed successfully with the 0.5% and 0.75% concentrations, and supplemental injections were not required. Second injections, however, were required with 0.375% ropivacaine. Anesthesia was unsuccessful in 13 patients given 0.25% ropivacaine even after 3 injections. The mean durations of soft tissue anesthesia were 3.3 ± 0.3 hours and 3.0 ± 0.3 hours for the 0.75% and 0.5% concentrations, but significantly shorter with more dilute concentrations. The duration of analgesia showed a similar pattern, with the 0.75% and 0.5% concentrations producing prolonged analgesia of 6.0 ± 0.4 hours and 5.6 ± 0.4 hours. These results indicate that 0.5% and 0.75% concentrations were effective for intraoral nerve blockade, with both a rapid onset and prolonged duration of pain control.

Keywords: Ropivacaine, Local anesthesia, Local anesthetics, Dentistry, Oral surgery

Received: August 26, 2005; Accepted: December 23, 2005

DOI: 10.2344/0003-3006(2006)53[3:AEODRC]2.0.CO;2

Address correspondence to Dr John A. Yagiela, UCLA School of Dentistry, Center for the Health Sciences, Los Angeles, CA 90095-1668; johny@dent.ucla.edu.

© 2007 The American Dental Society of Anesthesiology