title: Effect of preoperative acetaminophen/hydrocodone on the efficacy of the inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a prospective, randomized, double-blind, placebo-controlled study.
abstract: BACKGROUND
  The purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of the administration of the combination acetaminophen/hydrocodone on the anesthetic success of mandibular posterior teeth in patients experiencing symptomatic irreversible pulpitis.
  
  
  METHODS
  One hundred emergency patients in moderate to severe pain diagnosed with symptomatic irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, identical capsules of either a combination dose of 1000 mg acetaminophen/10 mg hydrocodone or placebo 60 minutes before the administration of a conventional inferior alveolar nerve (IAN) block. Endodontic access was begun 15 minutes after completion of the block, and all patients used for data analysis had profound lip numbness. Success was defined as no or mild pain (visual analog scale recordings) on pulpal access or instrumentation.
  
  
  RESULTS
  The success rate for the IAN block was 32% for the combination dose of 1000 mg acetaminophen/10 hydrocodone and 28% for the placebo dose, with no statistically significant difference between the 2 groups (P = .662).
  
  
  CONCLUSIONS
  A combination dose of 1000 mg acetaminophen/10 mg hydrocodone given 60 minutes before the administration of the IAN block did not result in a statistically significant increase in anesthetic success for mandibular posterior teeth in patients experiencing symptomatic irreversible pulpitis.
authors: Private Practice, Reno, Nevada.
authors: Spencer
authors: S
authors: Fullmer
authors: Division of Endodontics, The Ohio State University, Columbus, Ohio.
authors: Melissa
authors: M
authors: Drum
authors: Division of Endodontics, The Ohio State University, Columbus, Ohio. Electronic address: Reader.2@OSU.edu.
authors: Al
authors: A
authors: Reader
authors: Division of Endodontics, The Ohio State University, Columbus, Ohio.
authors: John
authors: J
authors: Nusstein
authors: Division of Oral Biology, The Ohio State University, Columbus, Ohio.
authors: Mike
authors: M
authors: Beck
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000766:Anesthesia, Dental; D000779:Anesthetics, Local / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001566:Benzocaine / Q000008:administration & dosage; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006853:Hydrocodone / Q000008:administration & dosage*; D008012:Lidocaine / Q000008:administration & dosage; D008046:Lip / Q000294:innervation; D008297:Male; D008340:Mandibular Nerve / Q000187:drug effects; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D017060:Patient Satisfaction; D010919:Placebos; D011292:Premedication; D011446:Prospective Studies; D011671:Pulpitis / Q000503:physiopathology / Q000628:therapy*; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D010919:Placebos; C083640:acetaminophen, hydrocodone drug combination; D000082:Acetaminophen; D006853:Hydrocodone; D008012:Lidocaine; D001566:Benzocaine
keywords: Acetaminophen; hydrocodone; inferior alveolar nerve block; symptomatic irreversible pulpitis