Burak ERGÜDER, Özlem AKKEMİK KIPÇAK, Ramazan KÖYMEN

Gömülü Alt Üçüncü Molar Diş Çekiminde Levobupivakain ve Artikainin Postoperatif Ağrı Giderme ve Lokal Anestezik Etkinliğinin Karşılaştırılması

Amaç: Gömülü üçüncü molar diş cerrahisinde %2 artikain ve %0,5 levobupivakainin postoperatif ağrı kesici ve klinik anestezik etkinliğinin karşılaştırılması.Materyal-Metot: Çalışmaya çift taraflı gömülü üçüncü büyük azı dişleri olan 53 hasta dahil edildi. Çift kör tekniği ile uygulanan çapraz randomize çalışmada, iki ayrı randevuda bir tarafta levobupivakain (Chirocaine %0.5), diğer tarafta artikain (Ultracaine %2) kullanılarak operasyon gerçekleştirildi. Her iki anestezik ilaç da vazokonstrüktör madde içermedi. anestezik ajanın etkisinin başlama süresi, operasyon süresi, operasyon sırasında kanama miktarı, hemodinamik parametreler, postoperatif analjezi ve anestezi süresi değerlendirildi. Hastadan postoperatif görsel ağrı değerlendirme skalası (VAS) ile ağrı derecesini işaretlemesi istendi.Bulgular: Articaine ile Anestezinin başlama süresi (80.28 ± 19.27 sn.) levobupivakaine kıyasla (136.69 ± 33.52 sn.) önemli ölçüde daha kısaydı. Levobupivakain ve artikain için ortalama postoperatif anestezi süresi sırasıyla 8 saat ve 3 saat idi (p = 0.000). Levobupivakain ve artikain için ortalama postoperatif analjezi süresi sırasıyla 7-8 saat ve 3 saat idi (p = 0.000). Ayrıca levobupivakain ile postoperatif görsel ağrı skala skorları postoperatif 4. saate kadar artikainden anlamlı derecede düşüktü. Levobupivakain ile yapılan ameliyatlarda belirgin olarak daha az kanama görüldü.Sonuç: %0.5 Levobupivakain, %2 artikaine kıyasla daha uzun postoperatif anestezi ve analjezi süresi, daha uzun anestezi başlangıcı ve daha az postoperatif ağrı ile sonuçlandı.

Anahtar Kelimeler:

Levobupivacaine, Articaine, Üçüncü molar cerrahisi, VAS

A Comparison of the Postoperative Pain Relief and Clinical Local Anesthetic Efficacy of Levobupivacaine and Articaine for Impacted Lower Third Molar Removal

Objective: A comparison of postoperative pain relief and clinical anesthetic efficacy of 2% articaine and 0.5% levobupivacaine in impacted third molar dental surgery. Material-Method: Fifty-three patients underwent the removal of symmetrically positioned lower third molars in 2 separate appointments under local anesthesia either with 2% articaine or 0.5% levobupivacaine in a double-blinded, randomized and crossover study. Neither anesthetic agent contained a vasoconstrictor. The time to onset of anesthesia, duration of surgery, intraoperative bleeding, hemodynamic parameters, the duration of postoperative analgesia and anesthesia as well as postoperative visual analogue scale (VAS) scores were evaluated.Results: The time to onset of anesthesia with articaine (80.28 ± 19.27 seconds) was significantly less compared to levobupivacaine (136.69 ± 33.52 seconds). The average duration of postoperative anesthesia for levobupivacaine and articaine was 8 hours and 3 hours, respectively (p = 0.000). The mean duration of postoperative analgesia for levobupivacaine and articaine was 7-8 hours and 3 hours, respectively (p = 0.000). Additionally, VAS scores with levobupivacaine were significantly lower than articaine up to the 4th postoperative hour. Significantly less bleeding was seen in the surgeries performed with levobupivacaine.Conclusion: 0.5% Levobupivacaine resulted in a longer period of postoperative anesthesia and analgesia, a longer time to onset of anesthesia, and less postoperative pain compared to 2% articaine.

Keywords:

Levobupivacaine, Articaine, Third molar surgery, VAS,

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