Comparative evaluation of effect of preoperative oral medication of ibuprofen and ketorolac on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis: a prospective, double-blind, randomized clinical trial.
BACKGROUND
Anesthetic efficacy of inferior alveolar nerve block decreases in patients with irreversible pulpitis. It was hypothesized that premedication with nonsteroidal anti-inflammatory drugs might improve the success rates in patients with inflamed pulps.


METHODS
Sixty-nine adult volunteers who were actively experiencing pain participated in this prospective, randomized, double-blind study. The patients were divided into 3 groups on a random basis and were randomly given 1 of the 3 drugs including ibuprofen, ketorolac, and placebo 1 hour before anesthesia. All patients received standard inferior alveolar nerve block of 2% lidocaine with 1:200,000 epinephrine. Endodontic access preparation was initiated after 15 minutes of initial inferior alveolar nerve block. Pain during treatment was recorded by using a Heft Parker visual analog scale. Success was recorded as none or mild pain.


RESULTS
Statistical analysis with nonparametric chi2 tests showed that placebo gave 29% success rate. Premedication with ibuprofen gave 27%, and premedication with ketorolac gave 39% success rate. There was no significant difference between the 3 groups.


CONCLUSIONS
Preoperative administration of ibuprofen or ketorolac has no significant effect on success rate of inferior alveolar nerve block in patients with irreversible pulpitis.
Aggarwal
Vivek
V
Department of Dental Surgery, Safdarjung Hospital, New Delhi, India. drvivekaggarwal@gmail.com
Singla
Mamta
M
Kabi
Debipada
D
D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods; D000779:Anesthetics, Local / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D020910:Ketorolac / Q000627:therapeutic use*; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008340:Mandibular Nerve / Q000187:drug effects; D009407:Nerve Block / Q000379:methods*; D011229:Preanesthetic Medication / Q000379:methods; D011292:Premedication / Q000379:methods*; D011446:Prospective Studies; D011671:Pulpitis / Q000601:surgery*; D012390:Root Canal Therapy / Q000379:methods; D018709:Statistics, Nonparametric; D055815:Young Adult
D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D008012:Lidocaine; D007052:Ibuprofen; D020910:Ketorolac