title: Evaluation of the combination of flurbiprofen and tramadol for management of endodontic pain.
abstract: Effective management of endodontic pain represents a continuing challenge. In this study, we evaluated the efficacy of flurbiprofen and a novel centrally acting analgesic, tramadol, alone and in combination, for reducing pain in endodontic emergency patients. Patients (n = 49) were administered a local anesthetic and underwent pulpectomy. They were then administered, on a double-blind basis, either: (i) placebo (one capsule to start and then every 6 h); (ii) flurbiprofen (100 mg loading dose and then 50 mg every 6 h); (iii) tramadol (100 mg loading dose and then 100 mg every 6 h); or (iv) the combination of flurbiprofen and tramadol (as above). Pulpectomy combined with placebo medication resulted in a 50% reduction in pain by 24 h (p < 0.01). Patients treated with flurbiprofen and tramadol reported less pain, compared with placebo treatment at 6 and 24 h (p < 0.01 for both). These results suggest that a nonsteroidal anti-inflammatory drug/opiate combination, together with endodontic therapy, may be useful in the management of endodontic pain.
authors.affiliation: Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Doroschak
authors.forename: W R
authors.initials: WR
authors.lastname: Bowles
authors.forename: K M
authors.initials: KM
authors.lastname: Hargreaves
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000704:Analysis of Variance; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D003788:Dental Pulp Diseases / Q000150:complications; D004311:Double-Blind Method; D004338:Drug Combinations; D004630:Emergencies; D005480:Flurbiprofen / Q000627:therapeutic use*; D006801:Humans; D010147:Pain Measurement; D018709:Statistics, Nonparametric; D014098:Toothache / Q000188:drug therapy* / Q000209:etiology; D014147:Tramadol / Q000627:therapeutic use*
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D014147:Tramadol; D005480:Flurbiprofen