Effect of pre-operative medication with paracetamol and ketorolac on the success of inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a double-blind randomized clinical trial
Kumar Umesh, Rajput Akhil, Rani Nidhi, Parmar Pragnesh, Kaur Amandeep, Aggarwal Vivek,
소속 상세정보
( Kumar Umesh ) - Post Graduate Institute of Medical Education and Research Oral Health Sciences Centre Unit of Conservative Dentistry and Endodontics
( Rajput Akhil ) - BSA Medical College and Hospital Department of Dentistry
( Rani Nidhi ) - Post Graduate Institute of Medical Education and Research Oral Health Sciences Centre Unit of Conservative Dentistry and Endodontics
( Parmar Pragnesh ) - Post Graduate Institute of Medical Education and Research Oral Health Sciences Centre Unit of Conservative Dentistry and Endodontics
( Kaur Amandeep ) - Regional Institute of Medical Sciences Dental College Department of Conservative Dentistry & Endodontics
( Aggarwal Vivek ) - Jamia Millia Islamia Faculty of Dentistry Department of Conservative Dentistry & Endodontics
Abstract
Background: The efficacy of local anesthesia decreases in patients with symptomatic irreversible pulpitis. Therefore, it was proposed that the use of premedication with an anti-inflammatory drug might increase the success rate of pulpal anesthesia in mandibular posterior teeth with vital inflamed pulp.
Methods: One hundred thirty-four patients who were actively experiencing pain willingly participated in this study. The Heft Parker (HP) visual analog scale (VAS) was used to record the initial pain intensity. Patients were randomly allocated to receive a placebo, 10 mg of ketorolac, and 650 mg of paracetamol. The standard inferior alveolar nerve block (IANB) was administered to all patients using 2% lidocaine with 1:200,000 adrenaline after one hour of medication. After 15 min, the patient was instructed to rate the discomfort during each step of the treatment procedure, such as access to remaining dentin, access to the pulp chamber, and during canal instrumentation on the HP VAS. IANB was considered successful if the patient reported no or mild pain during access preparation and instrumentation. Moderate or severe pain was classified as a failure of IANB and another method of anesthesia was used before continuing the treatment.
Results: The rate of successful anesthesia in the placebo, paracetamol, and ketorolac groups was 29%, 33%, and 43%, respectively, and no statistically significant difference was found between the groups.
Conclusion: Preoperative administration of paracetamol or ketorolac did not significantly affect the success rate of IANB in patients with irreversible pulpitis. No significant difference was observed between the paracetamol and ketorolac groups.
키워드
Inferior Alveolar Nerve; Ketorolac; Nerve Block; Paracetamol; Placebos; Pulpitis
원문 및 링크아웃 정보
등재저널 정보