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As a result ropivacaine was introduced into clinical practice.

Since then, it has been the focus of interest because of its increased cardiovascular safety compared with bupivacaine [8].

Results: The median duration of anaesthesia for the 7.5 mg/ml concentration of ropivacaine was approximately 6 hours, and for bupivacaine 5 mg/ml was approximately 7 hours.

Severity of impaction was rated as partial soft tissue impaction (PSI), complete soft tissue impaction (CSI), partial bony impaction (PBI), and complete bony impaction (CBI) [12].

However, after the report of cases of simultaneous seizure and cardiac arrest, with prolonged resuscitation and a disproportionally high number of deaths following unintended intravascular injection of bupivacaine [6], it became evident that bupivacaine differs from other local anaesthetics in that it has a narrower margin between the dose or plasma concentrations required to produce seizures and those resulting in cardiovascular collapse [7].

For this reason, there has been a search for alternative drugs with a greater margin of safety.

Patients Fifty patients referred to the Oral Surgery Department, Faculty of Dentistry, Mansoura University, for surgical removal of impacted lower third molars, were recruited in this study.

All subjects included were subjected to a formal case history taking as well as clinical and radiographic examinations.


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