Effect of Premedication with Three Oral Analgesics on the Success of Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis- A Randomized Control Trial

Abstract

Aim and Background: Irreversible pulpitis is a challenging condition in dentistry that requires prompt intervention. Achieving profound anesthesia in these cases is often difficult due to various factors such as inflammation, altered neural responses, and anatomical complexities. This study aimed to investigate the potential of a premedication regimen involving anti-inflammatory analgesics (ketorolac, diclofenac sodium, and naproxen) to enhance the efficacy of inferior alveolar nerve block (IANB) in managing irreversible pulpitis.

Methods: A double-blind randomized controlled trial was conducted involving 180 participants diagnosed with irreversible pulpitis. The participants were assigned to four groups: ketorolac, diclofenac sodium, naproxen, or placebo. Premedication was administered 45 minutes before IANB, and pain levels were assessed using a visual analog scale (VAS) at different time points during the procedure.

Results: The results showed that at 45 minutes before IANB, all three analgesics (ketorolac, diclofenac sodium, and naproxen) significantly reduced pain compared to the placebo group. At the time of local anesthesia administration, ketorolac and diclofenac sodium demonstrated significant pain reduction, while naproxen did not show a significant difference. During access cavity preparation, both ketorolac and diclofenac sodium significantly reduced pain compared to the placebo group, while naproxen did not show a significant difference.

Conclusion: The premedication regimen with ketorolac and diclofenac sodium proved to enhance the efficacy of local anesthesia in managing irreversible pulpitis. These findings suggest that anti-inflammatory analgesics can be used as an adjunctive treatment to improve pain management during endodontic procedures.