Addition of Buprenorphine to 2% Lignocaine with Adrenaline 1:80,000 for Postoperative Pain Control After Mandibular Third Molar Surgery - A Split Mouth Study

The pain after surgical extraction of impacted third molars is considered moderate to severe in intensity and is often used as a parameter for assessing the efficacy of various painkillers. A number of trials have examined the peripheral analgesic effect of opioids; following this certain studies have shown the local efficacy of Buprenorphine added to local anesthetic solution on effective pain control. However only few studies have been done in the field of maxillofacial surgery. To estimate the effectiveness of buprenorphine added to 2% lignocaine with adrenaline 1:80,000 in providing postoperative analgesia after mandibular third molar surgery. 15 consenting adult patients with bilaterally impacted mandibular third molars who were scheduled for surgical removal of the teeth were enrolled in the double - blinded study. The control side received lignocaine 2% with adrenaline 1:80,000 whereas the test side received Buprenorphine added to 2% lignocaine with adrenaline 1: 80,000 for nerve block. The study compared the post-operative pain on Visual Analogue Scale, quality of analgesia at various time intervals (every 2 hours for 24 hours, then at 36,48 and 72 hours), time at which 1st analgesic drug was consumed, and the total number of analgesic drugs consumed by the subjects to assess the effectiveness of buprenorphine in postoperative pain control. There was difference between the two groups in post-operative pain experienced as assessed on Visual Analogue Pain Scale, with results being statistically significant at 2nd and 4th hours (P values: 0.001 and 0.028) indicating better analgesia in buprenorphine- lignocaine group. The mean duration to analgesic consumption was 11.4 hours in buprenorphine with lignocaine group as compared to 2 hours in lignocaine group and was statistically significant (p value <0.001). The average consumption of NSAIDs was found to be 4.1 in buprenorphine with lignocaine group as compared to 7.27 in the lignocaine group (p value of <0.001).