Noguera-Gonzalez D, Cerda-Cristerna B I, Chavarria-Bolaños D, Flores-Reyes H, Pozos-Guillen A
Endodontic Postgraduate Program and Basic Sciences Laboratory, Faculty of Dentistry, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México.
Int Endod J. 2013 Nov;46(11):1056-62. doi: 10.1111/iej.12099. Epub 2013 Apr 6.
To evaluate the effect of preoperative oral ibuprofen (IBU) on the success of inferior alveolar nerve blocks (IANBs) with mepivacaine containing 1 : 100 000 epinephrine for patients with symptomatic irreversible pulpitis (SIP).
The present study was a double-blind, randomized, placebo-controlled clinical trial. The study included two study groups each consisting of 25 patients who exhibited symptomatic irreversible pulpitis of a mandibular posterior tooth. The patients presented prolonged moderate or severe pain (>10 s) after cold testing and indicated their pain scores on a Heft-Parker visual analogue scale. The patients received identically appearing capsules containing either 600 mg IBU (IBUg) or gelatin (placebo, PLAg) 1 h before administration of IANB with 2% mepivacaine containing 1 : 100 000 epinephrine. After 15 min, the anaesthetic blockade was assessed by a three-step examination (lip numbness, positive/negative response to cold testing and clinical discomfort during endodontic access). IANB success was defined as the absence of pain during any of these evaluations. The data were analysed using the chi-squared test.
All of the patients reported moderate or severe pain before the preoperative procedure. Statistically significant differences were observed between the IBUg and PLAg (P < 0.05); the success rates for the IANB were 72% (IBUg) and 36% (PLAg).
Preoperative oral administration of IBU significantly improved the efficacy of IANB in patients with symptomatic irreversible pulpitis.
评估术前口服布洛芬（IBU）对患有症状性不可逆性牙髓炎（SIP）的患者使用含1∶100 000肾上腺素的甲哌卡因进行下牙槽神经阻滞（IANB）成功率的影响。
本研究为双盲、随机、安慰剂对照临床试验。该研究包括两个研究组，每组由25例表现为下颌后牙症状性不可逆性牙髓炎的患者组成。患者在冷测试后出现持续的中度或重度疼痛（>10秒），并在Heft-Parker视觉模拟量表上表明其疼痛评分。患者在使用含1∶100 000肾上腺素的2%甲哌卡因进行IANB前1小时，服用外观相同的胶囊，其中包含600 mg IBU（IBUg组）或明胶（安慰剂，PLAg组）。15分钟后，通过三步检查（唇部麻木、冷测试阳性/阴性反应以及根管治疗操作期间的临床不适）评估麻醉阻滞效果。IANB成功定义为在任何一项评估中均无疼痛。使用卡方检验分析数据。
所有患者在术前均报告有中度或重度疼痛。IBUg组和PLAg组之间观察到统计学上的显著差异（P<0.05）；IANB的成功率分别为72%（IBUg组）和36%（PLAg组）。
术前口服IBU可显著提高症状性不可逆性牙髓炎患者IANB的疗效。
