Purpose:The aim of the study is to compare the efficacy of anesthesia and hemodynamic parameters of clonidine and epinephrine in lignocaine for lower third molar surgery.Materials and Methods:Thirty healthy controls with impacted mandibular third molar were randomly selected from both sexes between the age group of 20–47 years. Patients were divided equally into two groups: Group I (Adrenaline group) and Group II (Clonidine group). Patients received 2.5 ml of 2% lignocaine with adrenaline (12.5 μg/ml) in Adrenaline group and 2.5 ml of 2% lignocaine with clonidine (15 μg/ml) in Clonidine group. Hemodynamic parameters (heart rate, systolic blood pressure [SBP], diastolic blood pressure [DBP], and mean arterial pressure [MAP]) were recorded preoperatively, intraoperatively, and postoperatively. The onset of anesthesia and duration of anesthesia were recorded using pinprick test for both groups. Postoperatively, patients were evaluated for pain experience by the visual analog scale and verbal rating scale.Results:Lignocaine with clonidine intraoperatively and postoperatively decreases SBP and DBP and MAP compared to lignocaine with adrenaline. There was no significant difference in the onset and duration of anesthesia in both the groups. There was a statistically significant difference seen in the visual analog scale, but no statistically significant difference was seen in the verbal rating scale.Conclusion:Clonidine has similar efficacy as that of adrenaline with better hemodynamic parameters and can be used as an alternative to adrenaline for third molar surgeries.
Background Butorphanol tartrate, a mixed synthetic agonistantagonist opioid analgesic has been used for management of postoperative pain in minor and major surgical procedures.14,20 Tramadol hydrochloride is a centrally acting opioid which is effectively used in postoperative pain in various minor and major surgeries. Materials and methods Twenty subjects selected randomly received butorphanol tartrate 1 mg intramuscular and 20 subjects received tramadol hydrochloride 50 mg intramuscular after the removal of mandibular third molars. Time of injection, amount of anesthetic injected, duration of surgery, adverse effects were recorded.21 Results The mean amount of LA administered in butorphanol group was 2.6450 ml and in tramadol group was 2.640 ml respectively, the mean duration for surgery was 56.75 and 53.5 minutes for butorphanol and tramadol groups respectively which was statistically not significant. Pain assessment was done with VAS which showed mean of 19.2 and 15.5 mm (p = 0.001) which was significant for butorphanol and tramadol respectively after 12 hours. The mean time for rescue medication requirement was 5.9 hours (for tramadol) and 8.4 hours (for butorphanol). Effective analgesic activity was seen by butorphanol 1 mg intramuscular then tramadol 50 mg. Conclusion Butorphanol 1 mg was more effective than tramadol 50 mg in respect to postoperative analgesia. How to cite this article Hassan SS, Ahmed A, Rai M, Kalappa TM. Analgesic Efficacy of Tramadol and Butorphanol in Mandibular Third Molar Surgery: A Comparative Study. J Contemp Dent Pract 2012;13(3):364-370.
Abstract:The aim of the study was to record the etiology, pattern and management of zygomatico-maxillary complex (ZMC) fractures seen in two centres in Mysore and to compare the findings with other studies in literature. A fifteen year retrospective study involving 123 patients with ZMC fractures were selected from a pool of 219 patients who sustained maxillofacial fractures during the period under study. The age distribution, gender distribution, etiology, associated injuries, associated maxillofacial fractures, clinical features, distribution of radiographic investigation, radiographic findings associated with ZMC Fractures, pattern of fractures and various modalities of management and surgery were recorded. In this study, 86.17% were males and 13.83% females. Most (39.02%) patients were aged 21-30 years. There was highly significant association between road traffic accidents and ZMC fractures. (Chi square value 291.512, P < 0.001). The most frequently associated maxillofacial fracture was nasal bone fracture (28.45%). Circumorbital edema was the commonest clinical feature (88.61%); Keene's approach was the commonest method of zygoma elevation (78%). Two point internal fixation was commonly used (46.83%). Among two point fixation, frontozygomatic suture and zygomatico-maxillary suture were commonly plated (64.86%). Among one point internal fixation, zygomatico-maxillary suture was most commonly plated (40.74%). This study has shown that road traffic accidents have been responsible for most of the ZMC fractures in our geographical area and two point fixation at zygomatico-maxillary suture and fronto-zygomatic suture has been the commonest method of fixation and Keene's approach has been the choicest method for elevation of zygoma.
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