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Category: Volume 06 Issue 05 May 2018
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Title: Effect of Premedication with Ibuprofen and Meloxicam on the efficacy of Inferior Alveolar Nerve Block in Irreversible Pulpitis

Authors: Dr Suman Lamba, Dr Udaya Kumar Palani Swamy, Dr Mamta Kaushik, Dr Pallavi Y Reddy, Dr Pavan Kumar

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i5.46

Abstract

Pain relief in irreversible pulpitis cases with inferior alveolar nerve block is difficult, more-so in the case of mandibular molars. The present study evaluated the effect of premedication with non-steroidal anti-inflammatory drugs on local anaesthesia during endodontic therapy. In a prospective, randomised, double blinded clinical trial, 75 patients (25 per group) with symptomatic irreversible pulpitis were selected. They were given either placebo, 600 mg ibuprofen, or 7.5mg meloxicam an hour before local anaesthesia. Each participant recorded their pain score on a 10 centimetre visual analogue scale four times during the procedure. Pain was recorded: 1) before taking the analgesic, 2) 15 minutes after anaesthesia in response to an electric pulp test, 3) during access cavity preparation and 4) during biomechanical preparation. No or mild pain at any stage was reported as success. Data were analysed by the Kruskal-Wallis and one way analysis of variance tests. Ibuprofen and meloxicam showed significantly better results than placebo (p<0.05). The success rates were 92%, 88% and 60% for ibuprofen, meloxicam and placebo, respectively. There was no significant difference between ibuprofen and meloxicam (p>0.05). The study concludes premedication with ibuprofen and meloxicam significantly enhances the effectiveness of local anaesthesia in patients with irreversible pulpitis.

Keywords: Anaesthesia, inferior alveolar nerve block, irreversible pulpitis, placebo, premedication.

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Corresponding Author

Dr Suman Lamba

KIST Medical College, GPO Box: 14142,

Mahalaxmi Municipality, Ward No. 1, Lalitpur, NEPAL

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