IADR Abstract Archives
Comparison between premedication with oral ketorolac and ketorolac plus acetaminophen on the success rate of the inferior alveolar nerve block in asymptomatic irreversible pulpitis
Objectives: Effective management of endodontic pain represents a continuing challenge. The analgesic effects of a nonsteroidal anti-inflammatory drug (NSAID) are well known when inflammatory mediators were activated. The purpose of this Doubled Blind Controlled Randomized Clinical Trial was to determine Ketorolac versus Ketorolac/acetaminophen use for postoperative endodontic pain in asymptomatic patients with a diagnosis of Irreversible Pulpitis.
Methods: 66 patients - age 18-65 years - who had a molar tooth in mandible with irreversible pulpitis who scored their pain based on HP-VAS before treatment but with long-lasting response to cold test and also positive response to EPT and NO history of taking analgesics in the previous 24 hours or other drugs prior to presenting for treatment were divided by balanced block random allocation into three groups, a control group received a placebo medication, and two experimental groups, one received 10mg ketorolac and the other one received 10mg ketorolac plus 1000mg acetaminophen (blinded to both operator and patient) 45 minutes before inferior alveolar nerve block (IANB). All functional cusps were reducted in access cavity stage. canal preparation with continued up to losing Master Apical File at least file #30. patients were scored their pain with VAS as they experienced pain within 6,12,24,48 hours after treatment. The data were analyzed with Mann-Whiney, chi-square and Fisher exact tests.
Results: There were decreases in pain levels over time for the ketorolac and ketorolac plus acetaminophen groups. Chi-square test showed significant difference among the three groups (P value=0.001). premedication with ketorolac gave 95%, ketorolac plus acetaminophen gave 63.6% and placebo gave 45.5% success rate. Fisher's exact test showed significantly lower success rate in ketorolac plus acetaminophen and placebo than a ketorolac group in pairwise comparison (P value<0.05). It also showed no significant difference between ketorolac plus acetaminophen and placebo groups, although ketorolac plus acetaminophen had a better result.
Conclusions: Premedication with single oral dose of ketorolac significantly reduced postoperative endodontic pain in patients with asymptomatic irreversible pulpitis.
Methods: 66 patients - age 18-65 years - who had a molar tooth in mandible with irreversible pulpitis who scored their pain based on HP-VAS before treatment but with long-lasting response to cold test and also positive response to EPT and NO history of taking analgesics in the previous 24 hours or other drugs prior to presenting for treatment were divided by balanced block random allocation into three groups, a control group received a placebo medication, and two experimental groups, one received 10mg ketorolac and the other one received 10mg ketorolac plus 1000mg acetaminophen (blinded to both operator and patient) 45 minutes before inferior alveolar nerve block (IANB). All functional cusps were reducted in access cavity stage. canal preparation with continued up to losing Master Apical File at least file #30. patients were scored their pain with VAS as they experienced pain within 6,12,24,48 hours after treatment. The data were analyzed with Mann-Whiney, chi-square and Fisher exact tests.
Results: There were decreases in pain levels over time for the ketorolac and ketorolac plus acetaminophen groups. Chi-square test showed significant difference among the three groups (P value=0.001). premedication with ketorolac gave 95%, ketorolac plus acetaminophen gave 63.6% and placebo gave 45.5% success rate. Fisher's exact test showed significantly lower success rate in ketorolac plus acetaminophen and placebo than a ketorolac group in pairwise comparison (P value<0.05). It also showed no significant difference between ketorolac plus acetaminophen and placebo groups, although ketorolac plus acetaminophen had a better result.
Conclusions: Premedication with single oral dose of ketorolac significantly reduced postoperative endodontic pain in patients with asymptomatic irreversible pulpitis.