The effect of adding fentanyl to epinephrine-containing lidocaine on the anesthesia of maxillary teeth with irreversible pulpitis: a randomized clinical trial.
BACKGROUND
Deep and long-lasting anesthesia is essential throughout endodontic treatment. This study was conducted to compare the effect of adding fentanyl to epinephrine-containing lidocaine on depth and duration of local anesthesia in painful maxillary molars with irreversible pulpitis (IRP).


METHODS
This randomized double-blind, clinical trial with parallel design was conducted on 61 healthy volunteers; the control group received a mixture of normal saline and 2% lidocaine with 1:80000 epinephrine and the experimental group received a mixture of fentanyl and 2% lidocaine with 1:80000 epinephrine. The depth and duration of pulpal anesthesia were evaluated by means of electric pulp testing in 5-min intervals during a period of 60 min. Pain intensity was recorded five times: before injection, after injection, during access cavity preparation, initial file placement and pulpectomy using visual analog scale (VAS). All data were analyzed and compared using the chi-square and Mann-Whitney tests.


RESULTS
Except for one patient in the control group, all others had deep and long-lasting anesthesia. The difference between pain intensity of the control and experimental groups was not statistically significant (P>0.05).


CONCLUSIONS
Addition of fentanyl to conventional local anesthetic solution did not increase the effectiveness of infiltration in patients diagnosed with IRP.
Department of Endodontics, Dental Branch, Islamic Azad University, Tehran, Iran;
Payman
P
Mehrvarzfar
Department of Restorative Dentistry, Dental School, Shahid Beheshti University of Medical Science, Tehran, Iran;
Anahita
A
Pourhashemi
Private Practice, Tehran, Iran;
Fatemeh
F
Khodaei
Department of Oral and Maxillofacial Surgery, Dental Branch, Islamic Azad University, Tehran, Iran;
Behnam
B
Bohlouli
Department of Oral and Maxillofacial Surgery, Dental Branch, Islamic Azad University, Tehran, Iran;
Farzin
F
Sarkarat
Private Practice, Tehran, Iran;
Mojdeh
M
Kalantar Motamedi
Department of Endodontics, Dental School, Shahid Beheshti University of Medical Science, Tehran ,Iran.
Mohammad Karim
MK
Layegh Nejad
Department of Endodontics, Dental School, Shahid Beheshti University of Medical Science, Tehran ,Iran.
Sara
S
Zamaheni
Fentanyl; Infiltration; Irreversible Pulpitis; Lidocaine; Local Anesthesia; Maxillary Molars