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Effect of premedication on postoperative pain after root canal therapy in patients with irreversible pulpitis: a systematic review and meta-analysis

Journal of Dental Anesthesia and Pain Medicine 2021³â 21±Ç 5È£ p.397 ~ 411
Kumar Gaurav, Sangwan Pankaj, Tewari Sanjay,
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 ( Kumar Gaurav ) - Post Graduate Institute of Dental Sciences Rohtak
 ( Sangwan Pankaj ) - Post Graduate Institute of Dental Sciences Rohtak
 ( Tewari Sanjay ) - Post Graduate Institute of Dental Sciences Rohtak

Abstract


This systematic review aimed to assess the effect of premedication on postoperative pain after root canal treatment in vital teeth. Five electronic databases were searched for randomized clinical trials, and two independent reviewers selected eligible studies, extracted data, and assessed the quality of studies using the Cochrane Risk of Bias tool. Meta-analysis was conducted using the random-effects model, and the pooled effect estimate of the standardized mean difference (SMD) between premedication and placebo was calculated. Subgroup analysis was conducted based on the class and route of the drug. Studies with a high risk of bias were excluded from the sensitivity analysis. Ten trials satisfied the inclusion criteria, of which eight were included in the meta-analysis. Premedication was more effective in reducing postoperative pain than placebo at 6 hours (SMD = ?1.00; 95% confidence interval [CI] = ?1.33 to ?0.66), 12 hours (SMD = ?0.80; 95% CI = ?1.05 to ?0.56), and 24 hours (SMD = ?0.72; 95% CI = ?1.02 to ?0.43). The results of the sensitivity analysis confirmed the findings of the primary analysis. Based on these results, it can be concluded that premedication is effective in reducing postoperative pain in teeth with irreversible pulpitis. However, additional quality studies are required for further validation.

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Meta-Analysis; Postoperative Pain; Premedication; Root Canal Therapy; Systematic Review

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