Bupivacaine versus lidocaine for third molar surgery: A double-blind, randomized, crossover study

Purpose: The aim of this study was to compare the clinical use of bupivacaine to lidocaine in third molar surgery. Patients and Methods: Twenty-three subjects underwent surgical removal of their third molars in two separate procedures. Bupivacaine was used for the third molars on one side, whereas lidocaine was used on the other side. Pain experience, analgesic consumption, cardiovascular response, blood concentrations, and systemic toxicity were evaluated. Results: Bupivacaine significantly reduced the postoperative pain experience only at the 8-hour period (P <.05). No difference in analgesic requirements or cardiovascular responses was observed with the two local anesthetics. The mean blood concentrations of both agents were considerably lower than their respective toxic threshold concentrations. Conclusion: The results of this study do not show a difference in a variety of parameters, other than postoperative pain experience, when bupivacaine and lidocaine are compared in a standardized oral surgery procedure.