title: Does acetaminophen/hydrocodone affect cold pulpal testing 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 effects of a combination dose of 1000 mg acetaminophen/10 mg hydrocodone on cold pulpal testing 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 of 1000 mg acetaminophen/10 hydrocodone or placebo. Cold testing with Endo-Ice (1,1,1,2 tetrafluoroethane; Hygenic Corp, Akron, OH) was performed at baseline and every 10 minutes for 60 minutes. Pain to cold testing was recorded by the patient using a Heft-Parker visual analog scale. Patients' reaction to the cold application was also rated.
  
  
  RESULTS
  Cold testing at baseline and at 10 minutes resulted in severe pain for both the acetaminophen/hydrocodone and placebo groups. Although pain ratings decreased from 20-60 minutes, the ratings still resulted in moderate pain. Patient reaction to cold testing showed that 56%-62% had a severe reaction. Although the reactions decreased in severity over the 60 minutes, 20%-34% still had severe reactions at 60 minutes. Regarding pain and patients' reactions to cold testing, there were no significant differences between the combination acetaminophen/hydrocodone and placebo groups at any time period.
  
  
  CONCLUSIONS
  A combination dose of 1000 mg of acetaminophen/10 mg of hydrocodone did not statistically affect cold pulpal testing in patients presenting with symptomatic irreversible pulpitis. Patients experienced moderate to severe pain and reactions to cold testing.
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio. Electronic address: fowler.276@osu.edu.
authors.forename: Sara
authors.initials: S
authors.lastname: Fowler
authors.affiliation: Private Practice, Reno, Nevada.
authors.forename: Spencer
authors.initials: S
authors.lastname: Fullmer
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio.
authors.forename: Melissa
authors.initials: M
authors.lastname: Drum
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio.
authors.forename: Al
authors.initials: A
authors.lastname: Reader
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003080:Cold Temperature; D003782:Dental Pulp / Q000187:drug effects*; D003791:Dental Pulp Test; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006853:Hydrocodone / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010919:Placebos; D011446:Prospective Studies; D011671:Pulpitis / Q000503:physiopathology*; D013997:Time Factors; D014098:Toothache / Q000503:physiopathology; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D010919:Placebos; C083640:acetaminophen, hydrocodone drug combination; D000082:Acetaminophen; D006853:Hydrocodone
keywords: Acetaminophen; hydrocodone; pulp testing; symptomatic irreversible pulpitis