Comparison of Efficacy and Patient Response between 2% Lidocaine and 4% Articaine during Routine Dental Extractions

Abstract

Introduction: Local Anaesthetic (LA) agents are chemicals that reversibly block the transmission of action potential of nerve membrane. Lidocaine has established itself as the gold-standard owing to its excellent clinical properties with minimal side effects. Articaine, a relatively newer LA agent is reported to have better clinical properties than lidocaine. Aim: To compare and evaluate the differences in total volume of LA agent used, onset of subjective symptoms and objective signs, total duration of anaesthesia achieved and postoperative pain assessment with 2% lidocaine and 4% articaine during routine dental extractions. Materials and Methods: This randomised clinical study was conducted by the Department of Dentistry, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India, from October 2020 to February 2021. A total of 200 patients (107 females and 93 males) requiring mandibular molar extraction were included in the study. The patients were randomly divided into two study groups. Group-I patients were administered with 2% lidocaine while group-II patients were administered with 4% articaine. Complete demographic and clinical details of all the patients were recorded. The volume of LA agent used, onset time for subjective symptoms and objective signs and total duration of anaesthesia was recorded. Postoperative pain was recorded on Visual Analogue Scale (VAS) on a scale of 0 to 10. All the variables were recorded in Microsoft excel sheet and were analysed by Statistical Package for the Social Sciences (SPSS) version 21 software. A two-tailed p-value less than 0.05 (p0.05) were obtained for the following parameters-volume of LA agent used, onset time of subjective symptoms, onset time of objective signs and postoperative VAS scores. A statistically significant difference (p<0.05) was observed for total duration of anaesthesia. Conclusion: Both 2% lignocaine and 4% articaine are equally effective LA agents in patients undergoing mandibular molar extractions. However, 2% articaine exhibited significantly higher duration of total anaethesia when compared to 2% lidocaine.

Keywords

• inferior alveolar nerve block
• local anaesthetic agents
• mandibular first molar extraction
• visual analogue scale