Antinociceptive and Anti-inflammatory Effects of Diclofenac Sodium Along with B Vitamins on Acute Pulpitis

Abstract

Background: In acute pulpitis intense pain and inflammatory changes are the main features of the patients. Diclofenac sodium is commonly used in the treatment of dental pain but has many side effects. To reduce the dose and duration of traditional analgesic drugs several members of B vitamins (B 1 , B 6 , B 12 ) can be used. Objective: To observe the combined effects of diclofenac sodium with B vitamins in acute pulpitis patients. Method: This prospective interventional study was carried out in the Department of Physiology, Sir Salimullah Medical College (SSMC), Dhaka between July 2014 and June 2015. Ethical permission was taken from the Institutional Ethics Committee (IEC) of SSMC. Sixty diagnosed acute pulpitis patients of both sexes, aged 18-40 years were included by purposive sampling from the Out Patient Department of Dental unit of SSMC. They were divided into 2 groups (30 patients in each group), as diclofenac treated group received only diclofenac sodium (DS) for 5 days and combined treated group received combination of DS with B vitamins (BV) for same duration (DS&BV). Both the groups were studied two times i.e before taking Diclofenac Sodium on day 1 (DS d 1), after taking Diclofenac Sodium on day 5 (DS d 5) and before taking both DS with B vitamins on day 1 (DS & BV d 1), after taking both DS with B Vitamins on day 5 (DS & BV d 5). The intensity of pain was scored by Visual Analog Scale (VAS) by using a Verbal Descriptive Scale (VDS) as a guide. Again, serum CRP level was measured by latex method. The statistical analysis was done by paired sample't' test. Results: In this study, VAS score (p<0.001, p<0.01 respectively) and serum CRP (p<0.001) level were significantly reduced in acute pulpitis patients after 5 days treatment of diclofenac sodium with B vitamins supplementation in comparison to their pre supplemented state and to the patients treated with only diclofenac sodium. Conclusion: The present study revealed that, the combination of diclofenac sodium along with B vitamins reduce pain and inflammation more efficiently than the treatment with diclofenac alone.