A double-blind crossover study conducted by Branco, et al compared the anesthetic success, onset, and duration of lip and pulpal anesthesia of 2 local anesthetics, 0.5% bupivacaine and levobupivacaine solutions, both with 1:200,000 epinephrine, for use in inferior alveolar nerve anesthesia. Volunteers were randomly anesthetized using one of the solutions, and the inferior canine, second premolar, and molar were tested with electric stimulation to determine anesthetic success. The study found no significant differences between the solutions considering the measured parameters. Because levobupivacaine has been shown in the literature to have lower toxicity compared to recemic bupivacaine and R-bupivacaine, especially toward the cardiovascular system, the authors conclude that 0.5% levobupivacaine with 1:200,000 epinephrine could replace 0.5% bupivacaine with 1:200,000 epinephrine in inferior alveolar block anesthesia.
(Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, Vol. 101, No. 4, 2006)
