Private Practice, Rochester, NY.
Department of Periodontology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
J Endod. 2017 May;43(5):674-678. doi: 10.1016/j.joen.2016.12.017. Epub 2017 Mar 18.
Ibuprofen sodium dihydrate, a new formulation of ibuprofen, was introduced with the claim of faster onset of analgesia. Most of the data on this new ibuprofen formulation are drawn from studies using the oral surgery model. Because this model differs significantly from the endodontic pain model, we conducted a study comparing ibuprofen sodium dihydrate with conventional ibuprofen acid in endodontic pain patients.
This randomized, double-masked study recruited subjects experiencing moderate to severe pain from a tooth diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis (n = 41). Subjects were randomized to receive 400 mg ibuprofen acid (Advil; Pfizer, Madison, NJ) or an equivalent dose of 512 mg ibuprofen sodium dihydrate (Advil Sodium, Pfizer). The outcome measures were time to onset of 50% pain relief recorded using a stopwatch, reduction in spontaneous pain experienced on a 100-mm visual analog scale, and change in mechanical allodynia measured using a bite force transducer. The last 2 measures were obtained before and 60 minutes after administration of the drug.
The median time to onset of 50% pain relief after administration of ibuprofen sodium dihydrate was significantly faster compared with ibuprofen acid (26.5 vs 44 minutes, P = .08). Ibuprofen sodium dihydrate provided a greater reduction in spontaneous pain (50.8% vs 33.3%, P < .05) and mechanical allodynia (15% vs 9%, P > .05).
In endodontic pain patients, a single dose of ibuprofen sodium dihydrate provides faster onset of pain relief and a greater reduction in spontaneous and evoked pain compared with ibuprofen acid.
二水合布洛芬钠是一种新型布洛芬制剂,据称其镇痛作用更快。关于这种新布洛芬制剂的数据大多来自口腔外科模型研究。由于该模型与牙髓疼痛模型有很大不同,我们进行了一项比较二水合布洛芬钠与常规布洛芬酸在牙髓疼痛患者中的研究。
这项随机、双盲研究招募了因诊断为有症状的不可复性牙髓炎和有症状的根尖周炎而经历中度至重度疼痛的患者(n=41)。患者随机接受 400mg 布洛芬酸(Advil;辉瑞,新泽西州麦迪逊)或等效剂量的 512mg 二水合布洛芬钠(Advil Sodium,辉瑞)。主要终点是使用秒表记录的 50%疼痛缓解的起效时间,使用 100mm 视觉模拟量表记录的自发性疼痛减轻程度,以及使用咬合力换能器测量的机械性感觉过敏的变化。后 2 项测量在给药前和给药后 60 分钟进行。
二水合布洛芬钠给药后 50%疼痛缓解的中位起效时间明显快于布洛芬酸(26.5 分钟对 44 分钟,P=0.08)。二水合布洛芬钠能更显著地减轻自发性疼痛(50.8%对 33.3%,P<0.05)和机械性感觉过敏(15%对 9%,P>0.05)。
在牙髓疼痛患者中,单次给予二水合布洛芬钠可更快地缓解疼痛,并更显著地减轻自发性疼痛和诱发疼痛,效果优于布洛芬酸。