Efficacy of Magnesium Sulphate as an Adjunct to Lignocaine in Inferior Alveolar Nerve Block for Extraction of Mandibular Third Molar-A Split-Mouth Double-Blinded Randomized Controlled Trial.

Abstract

Background: Extensive ongoing research is aimed at enhancing the efficacy of inferior alveolar nerve block (IANB). Even though magnesium itself is not a primary analgesic, it has been shown to increase the effects of analgesics when used as an adjuvant or a supplement. Magnesium sulphate (MgSO₄) has reportedly been used to supplement regional blocks and spinal anaesthesia in various surgical procedures. Building on the concept of MgSO₄ as an analgesic adjuvant, our study aimed to assess its efficacy in increasing IANB success and controlling postsurgical pain. The split-mouth study evaluated the effectiveness of adding MgSO₄ to 2% lignocaine in improving block success and offering postsurgical pain relief after the transalveolar extraction of impacted mandibular third molars (MTMs). Methodology: We carried out a double-blinded, randomized, split-mouth study in 26 patients having bilateral impacted MTM. Patients presenting with impacted MTM bilaterally with a Pederson's score of ≤ 6 were included. The primary outcomes evaluated were the onset time, duration of anaesthesia, need for additional injections, and burning sensation during injection. The secondary outcomes assessed included postoperative pain relief and the quantity of rescue analgesics required. Results: The test side showed a significantly longer duration of analgesia than the control side (p < 0.001). The MgSO₄ group showed a lesser requirement for additional injections; however, it was not found to be statistically significant (0.289). No significant differences were seen in postoperative pain and the number of rescue analgesics. Conclusion: The addition of MgSO₄ to 2% lidocaine resulted in a significantly longer duration of analgesia. Trial Registration: CTRI identifier: CTRI/2018/05/013842.