Comparative Evaluation of Effect of Preoperative Oral Medication of Ibuprofen and Ketorolac on Anesthetic Efficacy of Inferior Alveolar Nerve Block with Lidocaine in Patients with Irreversible Pulpitis: A Prospective, Double-blind, Randomized Clinical Trial

Abstract 

Introduction

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.

Methods

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.

Results

Statistical analysis with nonparametric χ² 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.

Conclusions

Preoperative administration of ibuprofen or ketorolac has no significant effect on success rate of inferior alveolar nerve block in patients with irreversible pulpitis.

Key Words: Ibuprofen, inferior alveolar nerve block, irreversible pulpitis, ketorolac, NSAIDs