Effect of Bupivacaine on Postoperative Pain for Inferior Alveolar Nerve Block Anesthesia after Single-visit Root Canal Treatment in Teeth with Irreversible Pulpitis

IntroductionPain control after root canal treatment is of great importance in endodontic practice. The aim of the present study was to investigate the effect of a long-acting anesthetic (bupivacaine) on postoperative pain and the use of analgesics after root canal treatment.MethodsIn a randomized double-blinded clinical trial, 60 patients (30 per group) having first or second mandibular molars with irreversible pulpitis randomly received either 0.5% bupivacaine with 1:200,000 epinephrine or 2% lidocaine with 1:80,000 epinephrine as the anesthetic solutions for inferior alveolar nerve blocks. After single-visit root canal treatment, each patient recorded their pain score on a visual analogue scale at 6, 12, 24, 36, 48, and 72 hours after treatment. Data were analyzed by Mann-Whitney, χ2, Cochrane Q, and t tests as well as Pearson correlation analysis.ResultsThe results indicate that patients who received bupivacaine had significantly lower pain scores at 6 and 12 hours after root canal treatment compared with the patients who received lidocaine (P < .05). The use of analgesics in the bupivacaine patients was significantly lower than in the lidocaine group (P < .05).ConclusionsPatients who received bupivacaine as the anesthetic agent for single-visit endodontic treatment of irreversible pulpitis in mandibular molars had significantly less early postoperative pain and used fewer analgesics than those who had lidocaine as the anesthetic.