A pilot double blinded clinical trial to compare between Tramadol HCL and Lidocaine HCL as local anaesthesia amongst hospital-outpatient adult dental attendees Mosul-Iraq

Abstract

Aim of the study: The aim of the current study is to compare the local anesthetic action of tramadol HCL (with adrenaline) and lidocaine HCL (withadrenaline) in minor oral surgery.Method: A double blind study including 124 patients, requiring minor oral surgery (conventional tooth extraction, surgical removal of impactedteeth and periapical surgery) in the lower molar teeth, allocated randomly into two groups:Group A (n=62), in which each patient received initial dose of one dental cartridge, 1.8ml, from drug A (36mg of Lidocaine HCL with (0.0225mg)adrenalin), for conventional tooth extraction, doubled in case of surgical removal of impacted tooth and periapical surgery.Group B (n=62) received one dental cartridge, 1.8ml, from drug B (50 mg of tramadol HCL and (0.0225mg) adrenalin diluted to 1.8 ml by distilledwater), again this dose was doubled in case of surgical removal of impacted tooth and periapical surgery.For each patient the onset of anesthesia, number of cartridges used, duration of surgery and the degree of pain (with a 10-cm visual analog scaleVAS), had been recorded during the operation.Postoperatively, the patients were instructed to record exactly when the parasthesia disappear and anyadverse effects such as nausea andor vomiting on the first day of operation.Result: there was no significant difference between the two study groups in the number of cartridges (1.33/±0.510, 1.37/± 0.519)nor the onset ofanesthesia(2.95/±1.46, 3.14/±1.31) minutes, intraoperative pain (0.1935/±0.697, 0.2096/±0.656), duration of surgery (12.77/±10.51, 14.11/±11.66)minutes, and side effects. However there was a significant difference in duration of anesthesia(153.14/±35.10, 117.11/±26.88) minutes, where thegroup A achieved longer duration of action of local anesthesia.Conclusion: These study findings suggested that Tramadol HCL can be used as alternative to Lidocaine HCL in combination with adrenaline toachieve local anesthesia in situation where Lidocaine HCL is contraindicated or when adequate local anesthesia with minimal paraesthesia isrequired. Validation and replication of these study findings should be considered in future research.