Efficacy of lidocaine vs combination of lidocaine and bupivacaine in management of maxillofacial trauma: a clinical comparative study.
Bupivacaine
COVID-19
Lidocaine
Local anaesthesia
Journal
Clinical oral investigations
ISSN: 1436-3771
Titre abrégé: Clin Oral Investig
Pays: Germany
ID NLM: 9707115
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
14
03
2023
accepted:
11
09
2023
medline:
8
11
2023
pubmed:
21
9
2023
entrez:
21
9
2023
Statut:
ppublish
Résumé
The COVID-19 pandemic has created an unprecedented situation which the treatment of maxillofacial trauma, especially mandibular fractures that were previously managed using general anaesthesia had to be performed under local anaesthesia. In these cases, there was a requirement for an anaesthetic agent that would have a rapid onset but also provide a prolonged effect. The aim of the study was to evaluate the onset, duration, depth, required volume of anaesthesia of lidocaine with epinephrine versus combination of lidocaine and bupivacaine with epinephrine anaesthetic agents in surgical management of isolated mandibular fracture patients. A total of 30 patients with isolated mandibular fractures reported to our hospital included the study group. Patients were randomly distributed to two groups, Group A and Group B. Group A received local anaesthesia using 2% Lidocaine with 1:80,000 adrenaline and Group B received 0.5% Bupivacaine with 1:2,00,000 adrenaline combined with 2% Lidocaine with 1:80,000 adrenaline at a ratio of 1:1. The outcome variables were recorded and the data was tabulated and analysed using un-paired students t test. The combination of anaesthetic agents had longer duration of action (mean: 182.47 min, P-value: 0.001) and required lesser volume of anaesthetic solutions (mean: 5.38 mL, P-value: 0.001) as compared to usage of lidocaine alone. Although combination group showed quicker onset (mean: 4 min 8 s), the result was insignificant (p-value: 0.345). The study found that the combination of lidocaine and bupivacaine could serve as a potential anaesthetic cocktail in effective surgical management of isolated mandibular fractures. Maxillofacial injuries can be managed efficiently under local anaesthesia using combination of lidocaine and bupivacaine.
Sections du résumé
BACKGROUND
BACKGROUND
The COVID-19 pandemic has created an unprecedented situation which the treatment of maxillofacial trauma, especially mandibular fractures that were previously managed using general anaesthesia had to be performed under local anaesthesia. In these cases, there was a requirement for an anaesthetic agent that would have a rapid onset but also provide a prolonged effect. The aim of the study was to evaluate the onset, duration, depth, required volume of anaesthesia of lidocaine with epinephrine versus combination of lidocaine and bupivacaine with epinephrine anaesthetic agents in surgical management of isolated mandibular fracture patients.
METHODS
METHODS
A total of 30 patients with isolated mandibular fractures reported to our hospital included the study group. Patients were randomly distributed to two groups, Group A and Group B. Group A received local anaesthesia using 2% Lidocaine with 1:80,000 adrenaline and Group B received 0.5% Bupivacaine with 1:2,00,000 adrenaline combined with 2% Lidocaine with 1:80,000 adrenaline at a ratio of 1:1. The outcome variables were recorded and the data was tabulated and analysed using un-paired students t test.
RESULTS
RESULTS
The combination of anaesthetic agents had longer duration of action (mean: 182.47 min, P-value: 0.001) and required lesser volume of anaesthetic solutions (mean: 5.38 mL, P-value: 0.001) as compared to usage of lidocaine alone. Although combination group showed quicker onset (mean: 4 min 8 s), the result was insignificant (p-value: 0.345).
CONCLUSION
CONCLUSIONS
The study found that the combination of lidocaine and bupivacaine could serve as a potential anaesthetic cocktail in effective surgical management of isolated mandibular fractures.
CLINICAL RELEVANCE
CONCLUSIONS
Maxillofacial injuries can be managed efficiently under local anaesthesia using combination of lidocaine and bupivacaine.
Identifiants
pubmed: 37730891
doi: 10.1007/s00784-023-05267-w
pii: 10.1007/s00784-023-05267-w
doi:
Substances chimiques
Anesthetics, Local
0
Bupivacaine
Y8335394RO
Epinephrine
YKH834O4BH
Lidocaine
98PI200987
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Pagination
6613-6617Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Vilallonga R, de Gordejuela AGR, Cossio-Gil Y, Dominguez Gonzalez JM, Martin Sanchez R, Armengol Carrasco M (2020) Transforming a surgical department during the outbreak of new coronavirus pandemic. Clinical implications. Langenbeck’s Arch Surg. 405:867–75
doi: 10.1007/s00423-020-01931-x
Shah R, Priyadarshini G, Parsana M (2022) A systematic review on guidelines and recommendations for tracheostomy during COVID-19 pandemic. Indian J Otolaryngol Head Neck Surg 74(Suppl 2):2947–2958
doi: 10.1007/s12070-021-02517-9
pubmed: 33942020
Guraya SY (2020) Transforming laparoendoscopic surgical protocols during the COVID-19 pandemic; big data analytics, resource allocation and operational considerations. Int J Surg 1(80):21–25
doi: 10.1016/j.ijsu.2020.06.027
Somashekhar SP, Acharya R, Manjiri S, Talwar S, Ashwin KR, Rohit KC (2021) Adaptations and safety modifications to perform safe minimal access surgery (Minimally invasive surgery: Laparoscopy and Robotic) during the COVID-19 pandemic. Surg Innov 28(1):123–133
doi: 10.1177/1553350620964323
pubmed: 33026956
pmcid: 8685588
de Jong RH, Bonin JD (1981) Mixtures of local anesthetics are no more toxic than the parent drugs. Anesthesiology 54:177–181
doi: 10.1097/00000542-198103000-00001
pubmed: 7469099
Löfgren N, Lundquist B (1946) Studies on local anaesthetics: II. Svenks Kem Tidskr 58:206–217
Löfgren N (1948) Studies on Local Anesthetics: Xylocaine, a New Synthetic Drug. Morin Press, Worcester
Löfgren N, Tegner C (1960) Studies on local anesthetics: XX. Synthesis of some α-monoalkylamino-2-methylpropionanilides: a new useful local anesthetic. Acta Chem Scand 14:486–90
doi: 10.3891/acta.chem.scand.14-0486
Swerdlow M, Jones R (1970) The duration of action of bupivacaine, prilocaine and lignocaine. Br J Anaesth 42(4):335–339
doi: 10.1093/bja/42.4.335
pubmed: 4913413
Malamed SF (2012) Clinical action of specific agents. In: Malamed SF (ed) Handbook of Local Anesthesia, 6th edn. Mosby, Chicago, pp 52–73
Cox B, Durieux ME, Marcus MA (2003) Toxicity of local anesthetics. Best Pract Res Clin Anaesthesiol 17:111–136
doi: 10.1053/bean.2003.0275
pubmed: 12751552
Sinatra RS, Goldstein R, Sevarino FB (1991) The clinical effectiveness of apidural bupivacaine, bupivacaina with lidccaine, and bupivacaine with fentanyl for labor analgesia. J Clin Anesth 3:219–224
doi: 10.1016/0952-8180(91)90164-I
pubmed: 1878235
Sarvela PJ, Paloheimo MP, Nikki PH (1994) Comparison of pH-adjusted bupivacaine 0.75% and lidocaina 2%, both with hyaluronidase, in clay-case cataract surgery under regional anesthesia. Anesth Analg 79:35–39
doi: 10.1213/00000539-199407000-00008
pubmed: 8010450
Valvano MN, Leffler S (1996) Comparison of bupivacaine and lidocaine/bupivacaine for local anesthesia/digital nerve block. Ann Emerg Med 27:490–492
doi: 10.1016/S0196-0644(96)70239-1
pubmed: 8604868
Su N, Wang H, Zhang S, Liao S, Yang S, Huang Y (2014) Efficacy and safety of bupivacaine versus lidocaine in dental treatments: a meta-analysis of randomised controlled trials. Int Dent J 64(1):34–45
doi: 10.1111/idj.12060
pubmed: 24117122