Oral and Dental Research Center, Kerman University of Medical Sciences, Kerman, Iran.
J Endod. 2010 Sep;36(9):1450-4. doi: 10.1016/j.joen.2010.05.007. Epub 2010 Jul 3.
Achieving pulp anesthesia with irreversible pulpitis is difficult. This study evaluated whether nonsteroidal anti-inflammatory drugs assist local anesthesia.
In a randomized double-blinded clinical trial, 150 patients (50 per group) with irreversible pulpitis were given placebo, 600 mg ibuprofen, or 75 mg indomethacin 1 hour before local anesthesia. Each patient recorded their pain score on a visual analog scale before taking the medication, 15 minutes after anesthesia in response to a cold test, during access cavity preparation and during root canal instrumentation. No or mild pain at any stage was considered a success. Data were analyzed by the chi-square and analysis of variance tests.
Overall success rates for placebo, ibuprofen, and indomethacin were 32%, 78%, and 62%, respectively (p < 0.001). Ibuprofen and indomethacin were significantly better than placebo (p < 0.01). There was no difference between ibuprofen and indomethacin (p = 0.24).
Premedication with ibuprofen and indomethacin significantly increased the success rates of inferior alveolar nerve block anesthesia for teeth with irreversible pulpitis.
对于患有不可复性牙髓炎的患者，实现牙髓麻醉较为困难。本研究旨在评估非甾体类抗炎药（NSAIDs）是否有助于局部麻醉。
在一项随机、双盲的临床试验中，将 150 名（每组 50 名）患有不可复性牙髓炎的患者分为安慰剂组、600mg 布洛芬组和 75mg 吲哚美辛组，三组患者分别在接受局部麻醉前 1 小时服用相应药物。每位患者在服药前、麻醉后 15 分钟（冷测试）、开髓期间和根管预备期间使用视觉模拟评分法（VAS）记录疼痛评分。任何阶段无痛或轻度疼痛被认为是成功的。采用卡方检验和方差分析对数据进行分析。
安慰剂组、布洛芬组和吲哚美辛组的总体成功率分别为 32%、78%和 62%（p<0.001）。布洛芬组和吲哚美辛组明显优于安慰剂组（p<0.01）。布洛芬组和吲哚美辛组之间无差异（p=0.24）。
预先使用布洛芬和吲哚美辛可显著提高下颌神经阻滞麻醉治疗不可复性牙髓炎的成功率。
