Postoperative Pain Relief After Surgical Removal of Impacted Third Molars: A Single-Blind, Randomized, Controlled Study to Compare Levobupivacaine and Mepivacaine

Aim: To compare the efficacy of 0.75% levobupivacaine with that of 3% mepivacaine for pain control after surgical removal of impacted mandibular third molars. Methods: Forty-two subjects (23 females and 19 males, mean age 23.5 ± 4) underwent surgical removal of third molars in two separate sessions. Within each patient, levobupivacaine was used to anesthetize one extraction side and for the other side, mepivacaine. Onset of anesthesia, duration of surgery, lip numbness, timing of pain appearance and analgesic consumption were evaluated. Results: There were no significant differences in onset of anesthesia, duration of surgical procedure, and lower lip numbness between the two groups (P > .05). Timing of pain appearance and of first drug consumption was significantly lower in the mepivacaine group (P .05). Patients with levobupivacaine anesthesia had significantly lower visual analog (VAS) pain scores at 1 and 2 hours postoperatively than those with mepivacaine anesthesia. Conclusion: Levobupivacaine is a valid alternative to traditional local anesthetics for surgical removal of lower third molars. It presents better pain relief when compared to mepivacaine in the immediate postoperative period as evidenced by lower VAS scores. Keywords: anesthesia, levobupivacaine, oral surgery, postoperative pain, third molar