Comparison between lidocaine and 50/50 mixture of lidocaine with bupivacaine when used in inferior alveolar nerve and lingual nerve block for patients undergoing third molar surgery

Aim: The purpose of this study was to compare and evaluate the onset of action, duration of action and analgesia of a 50/50 mixture of lidocaine and bupivacaine when injected for surgical extraction of mandibular third molar. Materials and Method: 50 patients between the age group of 18 to 40 years undergoing bilateral mandibular third molar extractions, reporting to the Department of Oral and Maxillofacial Surgery were chosen for this study. Patients underwent extractions of bilateral mandibular third molars with inferior alveolar nerve and lingual nerve block. Extraction of the mandibular third molar on one side was done using 2.5 NSAIDS) taken was recorded at the end of 5th day.cc of 2% Lidocaine (with 1: 80,000 adrenaline) and the contralateral third molar was extracted using a mixture of 1.25cc of 2% Lidocaine (with 1: 80,000 adrenaline) + 1.25cc of 0.5% Bupivacaine( 50/50 mixture). Onset of action, duration of action was recorded based on EPT (Electronic pulp tester) response. Post operative analgesics ( Results: Independent sample t-test was used for statistical analysis. There was a statistical significant difference between two solutions in terms of both onset and duration of action. The combination of Lidocaine + Bupivacaine offered a prolonged duration of action in the patients undergoing third molar surgery. There was no difference in number of analgesics taken in both the groups. Conclusion: Prolonged duration of action of mixture of local anesthetic agent was not desirable in most minor surgical procedures performed by oral and maxillofacial surgeon. Consumption of NSAIDs noted to be same in both the groups makes no advantage of bupivacaine in terms of analgesia. There was no clinical advantage of mixing two anesthetic solutions even though Statistical differences noted in two parameters studied.