Effect of Presurgical use of NSAID and Steroids with Bupivacaine on post operative complications

Management of postoperative pain, swelling & trismus after surgical removal of mandibular impacted 3^rd molar is an important aspect for all the maxillofacial surgeons. The present study was conducted to analyze the efficacy of 2% Lidocaine Hcl with 1:80,000 adrenaline versus 0.5% Bupivacaine Hcl with presurgical administration of Ibuprofen 400mg & Dexamethasone 8mg in controlling post operative pain,swelling & trismus. The study was conducted on six groups of patients, 10 patients in each group. These groups were categorized as A, A1, B, B1, and C&C1. In the present study the mean onset of action with 2% Lidocaine Hcl is 2min. 33sec. & with 0.5% Bupivacaine Hcl is 3min 03sec. The mean duration of actions between Bupivacaine is 10hrs 16min compared to 4hrs 33min with Lidocaine, which helps in controlling postoperative pain experienced by the patients. Pain was recorded on a visual analog scale of 110 on 2, 3, 6,10,24,48 & 72hrs & 7^th postsurgical day. Swelling & Trismus was recorded on 1^st, 2^nd, 3^rd & 7^th postoperative day. Thus use of long acting anaesthetic agent with presurgical administration 8mg of dexamethasone appears to be the regime of choice in minor oral surgical procedures for reduction of postoperative complication like pain, swelling & trismus. However since the clinical material was rather limited more elaborate studies are required.