The Assessment of Prolonged Inferior Alveolar Nerve Blockade for Postoperative Analgesia in Mandibular Third Molar Surgery by a Perineural Addition of Dexamethasone to 0.5% Ropivacaine: A Randomized Comparison Study

Simona Stojanović, Nikola Burić, Milos Tijanić, Kosta Todorović, Kristina Burić, Nina Burić, Marija Jovanović, Vukadin Bajagić, Simona Stojanović, Nikola Burić, Milos Tijanić, Kosta Todorović, Kristina Burić, Nina Burić, Marija Jovanović, Vukadin Bajagić

Abstract

Background: Perineurally adding dexamethasone to local anesthetics could enable postoperative analgesia. Our aim was to investigate the efficacy of 4 mg dexamethasone and 0.5% ropivacaine on the prolonged duration of mandibular anesthesia for postoperative analgesia during third molar surgery. Materials and method: The patients of both sexes, and in the age range of 17 to 50 yrs of age, received the Gow-Gates anesthesia. Group I received 4 mL of plain 0.5% ropivacaine, with perineurally added 1 mL/4 mg of dexamethasone; group II received 4 mL of plain 0.5% ropivacaine with perineurally added 1 mL of 0.9% saline; group III received 4 mL of plain 0.5 bupivacaine with perineurally added 1 mL of 0.9% saline. The prime anesthesia outcome was the duration of conduction anesthesia (DCA); the secondary outcome was the duration of analgesia (DAN) and analgesia before analgesic intake. Results: In 45 randomly selected subjects (mean age 27.06 ± 8.20), DCA was statistically longest in group I (n = 15) (592.50 ± 161.75 min, p = 0.001), collated with groups II (n = 15) and III (n = 15) (307.40 ± 84.71 and 367.07 ± 170.52 min, respectively). DAN was significantly the longest in group I (mean: 654.9 ± 198.4 min, p = 0.001), compared with group II (345.4 ± 88.0 min) and group III (413.7 ± 152.3 min), with insignificant adverse reactions. One-third of the operated patients absented from the use of analgesics. Conclusion: A amount 0.5% ropivacaine with dexamethasone usefully served as an analgesic with a success rate of 93.4% of the given anesthesia.

Keywords: dexamethasone; mandibular anesthesia; postoperative analgesia; prolonged anaesthesia; ropivacaine.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The used numerical rating scale (Mc Caffery et al., 1989).
Figure 2
Figure 2
NRS assessment of pain during surgery. Abbreviations: rop + dex (plain 0.5% ropivacaine plus 1 mL dexamethasone, added perineurally), rop (plain 0.5% ropivacaine) and bup (0.5% plain bupivacaine).

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