The efficacy comparison of ibuprofen, acetaminophen-codeine, and placebo premedication therapy on the depth of anesthesia during treatment of inflamed teeth

Modaresi, Jalil; Dianat, Omid; Mozayeni, Mohammad Ali

doi:10.1016/j.tripleo.2005.10.053

Cited by 72 publications

(104 citation statements)

References 17 publications

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“…19,20 Multiple study results showed that NSAIDs used as premedication reduces pain and inflammation. [21][22][23] One study concluded that acetaminophen with codeine or ibuprofen improved the efficacy of inferior alveolar nerve block, 24 while another study showed that neither ibuprofen nor ketorolac caused any improvement. 25 Diclofenac is a benzoic acid derivative available as diclofenac sodium and diclofenac potassium, with sodium salt used more frequently.…”

Section: Jaypeementioning

confidence: 99%

Effectiveness of Premedication with Analgesics vs Placebo for Success of Inferior Alveolar Nerve Block in Irreversible Pulpitis

Wali¹,

Siddiqui²,

Qamar³

et al. 2012

International Journal of Prosthodontics and Restorative Dentistry

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Pain is considered to be the major cause for seeking emergency endodontic treatment. Pain management is of vital importance in endodontics with no exception. Local anesthesia is considered to be the primary method to control pain. An effective local anesthesia cannot be obtained if pulp is inflamed. Clinician prescribes nonsteroidal anti-inflammatory drugs (NSAIDs) as premedication on a routine basis for mild to moderate pain to reduce pulpal inflammation before injecting anesthesia. These drugs are beneficial in providing relief from pain and inflammation in irreversible pulpitis and helps in providing effectiveness of inferior alveolar nerve block. Moreover, they have a short half life, which would make them ideal for a single dosage prior to the management of severe pain. Aim To conduct a randomized-placebo controlled clinical trial to compare the effectiveness of premedication with analgesics vs placebo for success of inferior alveolar nerve block in irreversible pulpitis. Materials and methods The study consisted of 80 adult patients attending operative Outpatient Department in Baqai Dental College. Informed Consent was obtained from each participant. Subjects were randomly divided in four groups comprising of 20 subjects in each group. Group A received piroxicam (Feldene 20 mg, Pfizer), group B received diclofenac potassium (Fastaid Plus, 50 mg platinum pharmaceutic), group C received naproxen sodium (Synflex 550 mg, ICI), and group D received a placebo drug becefol (Abbott). Medication was given 1 hour before initiating endodontic treatment. After 1 hour of oral administration of tablets, inferior alveolar nerve block using 1.8 ml of 2% lidocaine containing 1: 200,000 epinephrine was given. After 15 minutes, access cavity preparation was initiated and patients were asked to inform if they experienced pain. Patients were excluded from the study if they experienced pain but if the patient did not feel pain endodontic treatment was continued. p-value was set at 0.05. Data was analyzed by using Chi-square test (SPSS 19). Results The result showed that out of 80 patients who participated in the study, success rate for piroxicam came out to 90% (10 male and 8 female patients), followed by diclofenac potassium with 75% success rate (9 male and 6 female patients), naproxen sodium with 35% success rate (3 male and 4 female patients) and placebo with 10% success (1 male and 1 female patient). Conclusion The current study concludes that premedication given 1 hour before injecting anesthesia is helpful in reducing pain intensity and thus causing inferior alveolar nerve block to be effective. How to cite this article Wali A, Siddiqui TM, Qamar N, Khan R, Jawaid N. Effectiveness of Premedication with Analgesics vs Placebo for Success of Inferior Alveolar Nerve Block in Irreversible Pulpitis. Int J Prosthodont Restor Dent 2012;2(1):5-9.

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Section: Jaypeementioning

confidence: 99%

Effectiveness of Premedication with Analgesics vs Placebo for Success of Inferior Alveolar Nerve Block in Irreversible Pulpitis

Wali¹,

Siddiqui²,

Qamar³

et al. 2012

International Journal of Prosthodontics and Restorative Dentistry

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“…As prostaglandins are considered inflammatory mediators,ibuprofen has been suggested to increase the efficacy of the inferior alveolar nerve block by interruption of prostaglandin production by inhibiting cyclo-oxygenase enzymes. Amongst drugs, ibuprofen is an interesting choice for analysis because in clinical trials it has yielded significant improvements in efficacy of IANB in patients diagnosed with irreversible pulpitis 7 . Premedication with ibuprofen and indomethacin significantly increased the success rates of inferior alveolar nerve block anesthesia for teeth with irreversible pulpitis 8 .…”

Section: Introductionmentioning

confidence: 99%

A comparative clinical study to evaluate the effectof premedication with Ibuprofen, Tramadol and combination of Ibuprofen and Acetaminophen on success of Inferior Alveolar Nerve Block in patients with Asymptomatic Irreversible Pulpitis.

Mahajan

Singh

Kaur

et al. 2017

Bangladesh J Med Sci

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Introduction: Aim of this study was to evaluate the effective of premedication and to determine the difference between non steroidal anti-inflammatory drugs and centrally acting opioids like tramadol on success rate of inferior alveolar nerve block in patients with asymptomatic irreversible pulpitis. Methods: This double blind clinical study was conducted on 60 patients with asymptomatic irreversible pulpitis in first or second mandibular molar with normal periapical radiographic findings. Three medications i.e., ibuprofen (600mg), tramadol (50 mg) and combination of ibuprofen (400 mg) + acetaminophen (325) were compared and lactose powder capsules were taken as placebo. All patients received IANB and teeth were examined with a cold pulp test using endofrost. Then, endodontic access cavity preparation was initiated. In case of pain during treatment, patients were asked to rate their pain on the visual analog scale. Results: The tramadol group showed significantly higher success rates but ibuprofen and combination of ibuprofen and acetaminophen groups were not significant with placebo (p>05). No Significant differences were there regarding sex of the patients. Conclusion: Premedication with tramadol increased the success rate of IANB.

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“…The high failure rate of inferior alveolar nerve (IAN) block in patients with irreversible pulpitis necessitates further investigations of alternative options for anesthesia (9,11,13). In the present study, preoperative administration of oral ketamine significantly decreased the amount of local anesthetic required to provide anesthesia, along with reduction of postoperative pain.…”

Section: Discussionmentioning

confidence: 62%

The effect of orally administered ketamine on requirement for anesthetics and postoperative pain in mandibular molar teeth with irreversible pulpitis

et al. 2011

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Achieving successful anesthesia and pain control in a predictable, efficient manner is a challenge in the endodontic treatment of vital inflamed lower molars. The aim of this study was to evaluate the effect of oral ketamine on the dosage of local anesthetics required and postoperative pain management for irreversibly inflamed mandibular molars. In this randomized double-blind placebocontrolled clinical trial, 36 patients with irreversibly inflamed mandibular molars were randomly divided into two groups of 18. Ten mg of ketamine dissolved in 20 ml of fruit juice was administered orally to patients in the experimental group. The control group was given 20 ml of fruit juice alone as a placebo. After 30 min, inferior alveolar nerve block (IANB) anesthesia was induced using one cartridge of 2% lidocaine and 1:100000 epinephrine. Teeth were tested after 5 to 10 min using an electrical pulp tester. In patients showing a positive response, another IANB injection was applied, and the total number of anesthetic cartridges used was recorded. Postoperative pain was evaluated using a visual analogue scale (VAS). In addition, use of analgesic in the first 24 h after treatment was monitored using a questionnaire. Data were analyzed by t test using SPSS software. There were no significant differences in age or gender between the two groups. The number of anesthetic cartridges used in the ketamine group was significantly less than that in the control group (P = 0.003). Furthermore, postoperative pain in the ketamine group was significantly lower (P = 0.019). Also the number of analgesic tablets taken in the ketamine group was significantly lower (P = 0.011). It can be concluded that a low dose of ketamine might be beneficial for enhancing the effect of local anesthetics. (J Oral Sci 53, 461-465, 2011)

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The efficacy comparison of ibuprofen, acetaminophen-codeine, and placebo premedication therapy on the depth of anesthesia during treatment of inflamed teeth

Cited by 72 publications

References 17 publications

Effectiveness of Premedication with Analgesics vs Placebo for Success of Inferior Alveolar Nerve Block in Irreversible Pulpitis

Effectiveness of Premedication with Analgesics vs Placebo for Success of Inferior Alveolar Nerve Block in Irreversible Pulpitis

A comparative clinical study to evaluate the effectof premedication with Ibuprofen, Tramadol and combination of Ibuprofen and Acetaminophen on success of Inferior Alveolar Nerve Block in patients with Asymptomatic Irreversible Pulpitis.

The effect of orally administered ketamine on requirement for anesthetics and postoperative pain in mandibular molar teeth with irreversible pulpitis

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