Effect of combination of preoperative ibuprofen/acetaminophen on the success of the inferior alveolar nerve block in patients with symptomatic irreversible pulpitis

J Endod. 2011 May;37(5):593-7. doi: 10.1016/j.joen.2011.02.015. Epub 2011 Mar 22.

Abstract

Introduction: The purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of the administration of the combination of preoperative ibuprofen/acetaminophen on the success of the inferior alveolar nerve (IAN) block in patients with symptomatic irreversible pulpitis.

Methods: One hundred endodontic emergency patients in moderate to severe pain diagnosed with irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, identical capsules of either a combination of 800 mg ibuprofen and 1000 mg acetaminophen or placebo 45 minutes before the administration of a conventional IAN block. Access was begun 15 minutes after completion of the IAN block, and all patients had profound lip numbness. Success was defined as no or mild pain (visual analog scale recordings) on access or initial instrumentation.

Results and conclusions: The success rate for the IAN block was 32% for the combination ibuprofen/acetaminophen group and 24% for the placebo, with no significant difference (P = .37) between the 2 groups. For mandibular posterior teeth, a combination dose of 800 mg ibuprofen and 1000 mg acetaminophen given 45 minutes before administration of the IAN block did not result in a statistically significant increase in anesthetic success in patients with symptomatic irreversible pulpitis.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetaminophen / administration & dosage
  • Acetaminophen / therapeutic use*
  • Adult
  • Analgesics, Non-Narcotic / administration & dosage
  • Analgesics, Non-Narcotic / therapeutic use*
  • Anesthetics, Local / administration & dosage
  • Bicuspid / drug effects
  • Carticaine / administration & dosage
  • Dental Pulp / drug effects
  • Dentin / drug effects
  • Double-Blind Method
  • Drug Combinations
  • Female
  • Humans
  • Ibuprofen / administration & dosage
  • Ibuprofen / therapeutic use*
  • Lip / innervation
  • Male
  • Mandibular Nerve / drug effects*
  • Molar / drug effects
  • Molar, Third / drug effects
  • Nerve Block / methods*
  • Pain Measurement
  • Placebos
  • Premedication*
  • Prospective Studies
  • Pulpitis / therapy*
  • Root Canal Preparation / methods
  • Treatment Outcome

Substances

  • Analgesics, Non-Narcotic
  • Anesthetics, Local
  • Drug Combinations
  • Placebos
  • Acetaminophen
  • Carticaine
  • Ibuprofen