Long-acting analgesic or long-acting local anesthetic in controlling immediate postoperative pain after lower third molar surgery.

In a double-blind crossover study, the effect on postoperative pain of lidocaine plus diflunisal was compared with that of bupivacaine and placebo. Forty-eight patients with bilateral impactions of lower third molars had these removed on two occasions four weeks apart. One pain-control regimen was used on one occasion and the alternate on the second. The pain intensity was indicated on a visual analog scale at 2, 3, 4, 5, and 6 hours postoperatively. The pain values for the first postoperative hours were higher for the lidocaine diflunisal combination, whereas after 5 hours the opposite was true. Significantly more patients preferred the combination of lidocaine and diflunisal. Three patients reported fatigue postoperatively during the day of surgery, which they attributed to the operation and not to the analgesics used.