Department of Dental Surgery, Safdarjung Hospital, New Delhi, India.
J Endod. 2010 Mar;36(3):375-8. doi: 10.1016/j.joen.2009.11.010.
Anesthetic efficacy of inferior alveolar nerve block decreases in patients with irreversible pulpitis. It was hypothesized that premedication with nonsteroidal anti-inflammatory drugs might improve the success rates in patients with inflamed pulps.
Sixty-nine adult volunteers who were actively experiencing pain participated in this prospective, randomized, double-blind study. The patients were divided into 3 groups on a random basis and were randomly given 1 of the 3 drugs including ibuprofen, ketorolac, and placebo 1 hour before anesthesia. All patients received standard inferior alveolar nerve block of 2% lidocaine with 1:200,000 epinephrine. Endodontic access preparation was initiated after 15 minutes of initial inferior alveolar nerve block. Pain during treatment was recorded by using a Heft Parker visual analog scale. Success was recorded as none or mild pain.
Statistical analysis with nonparametric chi2 tests showed that placebo gave 29% success rate. Premedication with ibuprofen gave 27%, and premedication with ketorolac gave 39% success rate. There was no significant difference between the 3 groups.
Preoperative administration of ibuprofen or ketorolac has no significant effect on success rate of inferior alveolar nerve block in patients with irreversible pulpitis.
患有不可复性牙髓炎的患者，下颌神经阻滞的麻醉效果会降低。有人假设，在使用麻醉药物之前使用非甾体类抗炎药可能会提高牙髓发炎患者的成功率。
69 名成年志愿者主动参与了这项前瞻性、随机、双盲研究。这些患者随机分为 3 组，随机给予 3 种药物中的 1 种，包括布洛芬、酮咯酸和安慰剂，在麻醉前 1 小时给药。所有患者均接受 2%利多卡因加 1:200000 肾上腺素标准下颌神经阻滞。初始下颌神经阻滞 15 分钟后开始进行牙髓治疗。使用 Heft Parker 视觉模拟量表记录治疗过程中的疼痛。成功定义为无或轻度疼痛。
非参数卡方检验的统计分析显示，安慰剂的成功率为 29%。布洛芬预处理的成功率为 27%，酮咯酸预处理的成功率为 39%。3 组间无显著差异。
对于患有不可复性牙髓炎的患者，术前使用布洛芬或酮咯酸对下颌神经阻滞的成功率没有显著影响。
