The Effect of Premedication with Ibuprofen and Indomethacin on the Success of Inferior Alveolar Nerve Block for Teeth with Irreversible Pulpitis

Abstract 

Introduction

Achieving pulp anesthesia with irreversible pulpitis is difficult. This study evaluated whether nonsteroidal anti-inflammatory drugs assist local anesthesia.

Methods

In a randomized double-blinded clinical trial, 150 patients (50 per group) with irreversible pulpitis were given placebo, 600 mg ibuprofen, or 75mg 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.

Results

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).

Conclusions

Premedication with ibuprofen and indomethacin significantly increased the success rates of inferior alveolar nerve block anesthesia for teeth with irreversible pulpitis.

Key Words: Anesthesia, ibuprofen, indomethacin, inferior alveolar nerve block, irreversible pulpitis, nonsteroidal anti-inflammatory drugs, placebo