title: Sniffing out endodontic pain: use of an intranasal analgesic in a randomized clinical trial.
abstract: BACKGROUND
  Orofacial pain is a common encounter in dentistry (affecting 12% of the population) and is a primary reason for patients seeking emergency care. Dentists often prescribe oral analgesics, which have disadvantages of decreased absorption rates and delayed onset. Intranasal (IN) delivery takes advantage of a large surface area of mucosal tissue for rapid absorption. The purpose of this study was to evaluate the efficacy of IN ketorolac for endodontic pain using a randomized, double-blind, placebo-controlled parallel design study.
  
  
  METHODS
  Twenty-two patients presenting with moderate to severe endodontic pain were selected to receive IN treatment with placebo (n = 11) or ketorolac (n = 11) 30 minutes before endodontic treatment was started and immediately after the completion of endodontic treatment. Baseline pain levels were recorded before IN treatment. Pain levels were also recorded at 15 and 30 minutes after the initial IN dosing (before endodontic treatment); 30 minutes after completion of endodontic treatment; and 4, 8, and 12 hours after the initial IN spray. Primary analysis was a repeated-measures analysis of variance.
  
  
  RESULTS
  IN ketorolac alone or with endodontic treatment showed significantly better pain relief compared with IN placebo spray alone or with endodontic treatment at 30 minutes after the first or second intranasal dose and at 4 hours after the first intranasal dose (P = .03).
  
  
  CONCLUSIONS
  These results suggest that IN ketorolac may provide a novel and efficacious method for pain relief in endodontic pain patients.
authors.affiliation: University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Casey L
authors.initials: CL
authors.lastname: Turner
authors.forename: Garry W
authors.initials: GW
authors.lastname: Eggleston
authors.forename: Scott
authors.initials: S
authors.lastname: Lunos
authors.forename: Neil
authors.initials: N
authors.lastname: Johnson
authors.forename: Tim S
authors.initials: TS
authors.lastname: Wiedmann
authors.forename: Walter R
authors.initials: WR
authors.lastname: Bowles
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002908:Chronic Disease; D003788:Dental Pulp Diseases / Q000628:therapy*; D003790:Dental Pulp Necrosis / Q000628:therapy; D004311:Double-Blind Method; D005157:Facial Pain / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020910:Ketorolac / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010482:Periapical Abscess / Q000628:therapy; D010485:Periapical Periodontitis / Q000628:therapy; D010919:Placebos; D011292:Premedication; D011446:Prospective Studies; D011671:Pulpitis / Q000628:therapy; D012390:Root Canal Therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010919:Placebos; D020910:Ketorolac