Effect of PARA, IBUP ACEC on Success of Maxillary Infiltration Anaesthesia in Patients with Irreversible Pulpitis

Table of Content

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
Table 1: The post-injection VAS scores

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)
Figure 1: Rate of successful anaesthesia

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