Ropivacaine effect on hemostasis and pain level in patients undergoing orthognathic surgery: a triple-blinded, randomized, clinical trial.

Abstract

Objective: This triple-blind, controlled clinical trial aimed to assess the effects of ropivacaine and lidocaine on hemodynamic factors, blood loss, opioid consumption, and postoperative pain in patients undergoing orthognathic surgery.

Methods: Thirty-two patients with Class III malocclusion scheduled for orthognathic surgery were included. The participants were randomly assigned to receive 0.5% ropivacaine or 2% lidocaine with 1:80,000 epinephrine for local anesthesia (n = 16). Hemodynamic parameters were recorded at various time intervals, which included heart rate (HR), systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation (SpO₂), intraoperative bleeding, opioid consumption, and postoperative pain intensity.

Results: The participants' mean age was 23.67 ± 4.56 years, and 75% were female. The groups were comparable in most measured outcomes. HR was significantly higher in the ropivacaine group at 30 and 60 min post-injection (P < 0.05). SpO₂ percentages were comparable between the groups, except at 15 min post-anesthesia, where the lidocaine group demonstrated a significantly higher SpO₂ (P = 0.029). Blood pressure, postoperative opioid consumption, intraoperative bleeding, and postoperative pain levels showed no statistically significant differences between the two groups.

Conclusion: Within the limitations of this study, both 0.5% ropivacaine and lidocaine with epinephrine demonstrated comparable effects on hemodynamic stability, intraoperative blood loss, postoperative pain levels, and opioid consumption in patients undergoing orthognathic surgery. These findings suggest that ropivacaine may serve as a safe and effective alternative to lidocaine for local anesthesia in orthognathic procedures.