Franco-de la Torre Lorenzo, Gómez-Sánchez Eduardo, Serafín-Higuera Nicolás Addiel, Alonso-Castro Ángel Josabad, López-Verdín Sandra, Molina-Frechero Nelly, Granados-Soto Vinicio, Isiordia-Espinoza Mario Alberto
Instituto de Investigación en Ciencias Médicas, Departamento de Clínicas, División de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos 47620, Jalisco, Mexico.
Departamento de Ciencias Fisiológicas, División de Disciplinas Básicas para la Salud, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico.
Pharmaceuticals (Basel). 2022 Jul 16;15(7):878. doi: 10.3390/ph15070878.
Inferior alveolar nerve block (IANB) has a high failure rate in subjects with symptomatic irreversible pulpitis (SIP). It has been suggested that drugs with anti-inflammatory activity could improve the efficacy of the anesthetic used for IANB. The aim of this study was to assess the effect of dexamethasone on the success of dental anesthesia in patients with SIP. An information search was performed using PubMed and Google Scholar. The risk of bias of the included studies was evaluated with the Cochrane Collaboration’s risk-of-bias tool. The anesthetic success rate, pain intensity (VAS), and adverse effects were extracted. Data were analyzed using the Mantel−Haenszel test and odds ratio or the inverse variance and standardized mean difference. Dexamethasone increased the anesthetic success in comparison with placebo (n = 502; p < 0.001; OR = 2.59; 95% CIs: 1.46 to 4.59). Moreover, patients who were given dexamethasone had lower pain scores at 6 h (n = 302; p < 0.001; MD= −1.43; 95% CIs: −2.28 to −0.58), 12 h (n = 302; p < 0.0001; MD = −1.65; 95% CIs: −2.39 to −0.92), and 24 h (n = 302; p < 0.0008; MD = −1.27; 95% CIs: −2.01 to −0.53) when compared with placebo. In conclusion, the systemic administration of dexamethasone increases the anesthetic success rate and improves pain management in patients with SIP.
下牙槽神经阻滞（IANB）在有症状的不可逆性牙髓炎（SIP）患者中失败率较高。有人提出，具有抗炎活性的药物可能会提高用于IANB的麻醉剂的疗效。本研究的目的是评估地塞米松对SIP患者牙科麻醉成功率的影响。使用PubMed和谷歌学术进行信息检索。使用Cochrane协作网的偏倚风险工具评估纳入研究的偏倚风险。提取麻醉成功率、疼痛强度（视觉模拟评分法）和不良反应。使用Mantel-Haenszel检验和比值比或逆方差及标准化均数差进行数据分析。与安慰剂相比，地塞米松提高了麻醉成功率（n = 502；p < 0.001；OR = 2.59；95%置信区间：1.46至4.59）。此外，与安慰剂相比，接受地塞米松治疗的患者在6小时（n = 302；p < 0.001；MD = -1.43；95%置信区间：-2.28至-0.58）、12小时（n = 302；p < 0.0001；MD = -1.65；95%置信区间：-2.39至-0.92）和24小时（n = 302；p < 0.0008；MD = -1.27；95%置信区间：-2.01至-0.53）时疼痛评分更低。总之，全身给予地塞米松可提高SIP患者的麻醉成功率并改善疼痛管理。
