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Bupivacaine Duration — NDEB AFK MCQ

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ModeratePain & Anxiety ControlBupivacaine DurationNDEB AFK

Which local anaesthetic has the longest duration of action and is particularly useful for postoperative pain control after third molar surgery?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Bupivacaine 0.5% with 1:200,000 epinephrine

Bupivacaine 0.5% with 1:200,000 epinephrine provides the longest duration of anaesthesia of any dental local anaesthetic — up to 8-12 hours for an IAN block. Its long duration provides extended postoperative analgesia, reducing the need for systemic analgesics in the early post-surgical period. The maximum dose is 1.3 mg/kg (up to 90 mg absolute maximum). It should be used with caution due to its cardiotoxicity if inadvertently injected intravascularly.

Reference: Malamed – Handbook of Local Anesthesia, 7th ed., 2020