Introduction
Anaesthesia is one of the pre-requisites of commencing endodontic treatment. Local anaesthetics are highly effective in producing anaesthesia in normal tissues; however, they commonly fail in patients with inflamed tissues.
Aim
To compare the efficacy of oral premedication of paracetamol (PARA), ibuprofen (IBUP), aceclofenac (ACEC), and a placebo (PLAC) medication on anaesthetic efficacy of maxillary infiltration of lidocaine with 1:200,000epinephrine in patients with irreversible pulpitis
Patient Profile
- Healthy patients (ASA I or ASA II) with a vital maxillary first molar experiencing intermittent or spontaneous pain
Methods
- A prospective, randomized, double-blinded study
- N= 120
- The success of the technique was defined as the ability to access and extripate pulp without pain (VAS = 0 mm) or mild discomfort/sensitivity (VAS ≤ 54 mm)
- If the score was ≤54 mm, the outcome was recorded as a failure, and supplementary anaesthesia was administered, and the procedure was completed
- The post-injection VAS scores were recorded at the end of the procedure
Results
- There was a significant difference between the PLAC and the three drug groups.
- IBUP and ACEC groups demonstrated significantly lower scores than the PARA group (Table 1)
- There was no significant difference between IBUP and ACEC groups
|
Treatment Group |
Post- Injection Visual Analog Scale Score |
P-value |
|
PARA |
20 |
|
|
IBUP |
5 |
P<0.001 |
|
ACEC |
6 |
|
|
PLAC |
40 |
|
- The percentage of successful anaesthesia was significantly higher in all the drug groups when compared with the PLAC group (figure 1)
Conclusion
The study demonstrated that oral premedication with 800 mg IBUP, 100 mg ACEC, and 1000 mg PARA resulted in a significantly higher percentage of successful maxillary infiltration anaesthesia in patients with irreversible pulpitis
Reference
J Conserv Dent. 2012;15;4: 310–314