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Comparison of the Anesthetic Efficacy between Bupivacaine and Lidocaine in Patients with Irreversible Pulpitis of Mandibular Molar

  • Sampaio, Roberta Moura
  • Carnaval, Talita Girio
  • Lanfredi, Camila Bernardeli
  • Horliana, Anna Carolina Ratto Tempestini...
  • Rocha, Rodney Garcia
  • Peixoto, Isabel de Freitas
Publication Date
Jan 01, 2012
Biblioteca Digital da Produção Intelectual da Universidade de São Paulo (BDPI/USP)
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Introduction: The purpose of this study was to compare the anesthetic efficacy of 0.5% bupivacaine with 1:200,000 epinephrine with that of 2% lidocaine with 1:100,000 epinephrine during pulpectomy in patients with irreversible pulpitis in mandibular posterior teeth. Methods: Seventy volunteers, patients with irreversible pulpitis admitted to the Emergency Center of the School of Dentistry at the University of Sao Paulo, randomly received a conventional inferior alveolar nerve block containing 3.6 mL of either 0.5% bupivacaine with 1:200,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine. During the subsequent pulpectomy, we recorded the patients subjective assessments of lip anesthesia, the absence/presence of pulpal anesthesia through electric pulp stimulation, and the absence/presence of pain through a verbal analog scale. Results: All patients reported lip anesthesia after the application of either inferior alveolar nerve block. By measuring pulpal anesthesia success with the pulp tester, lidocaine had a higher success rate (42.9%) than bupivacaine (20%). For patients reporting none or mild pain during pulpectomy, the success rate of bupivacaine was 80% and lidocaine was 62.9%. There were only statistically significant differences to the success of pulpal anesthesia. Conclusions: Neither of the solutions resulted in an effective pain control during irreversible pulpitis treatments of mandibular molars. (J Endod 2012;38:594-597)

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