Comparative Evaluation of Pulpal Anaesthetic Efficacy of Different Anaesthetic Solutions for Inferior Alveolar Nerve Block in Patients With Symptomatic Irreversible Pulpitis

Dr. Vivek Aggarwal

Status: Completed

Conditions: Pulpitis

Treatments: Drug: local anaesthetic injection

Study type: Interventional

Funder types: Other

Identifiers

NCT05239078

SGTTHESIS

Details and patient eligibility

About

Pulpal and periapical inflammation and infection can cause tissue pH in the affected region to be lowered which results in less penetration of anesthetic solution in the nerve membrane and hence delays the onset of anesthesia. So, the purpose of this study was to compare the pulpal anesthetic efficacy of lidocaine, articaine, mepivacaine for inferior alveolar nerve block (IANB) in patients with irreversible pulpitis (IP). One hundred and twenty adult patients with IP concerning mandibular molars randomly received IANB with either of the three solutions: 2% lidocaine with epinephrine; 4% articaine with epinephrine; 3% plain mepivacaine. Pain during the endodontic treatment was assessed using a visual analog scale (Heft-Parker VAS). Endodontic treatment was initiated. Success was defined as no or mild pain (pain score≤54mm on Hp VAS) during access preparation and root canal instrumentation. The anesthetic success rates were analyzed with the chi-square test.

Enrollment: 120 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• active pain in a mandibular molar
• prolonged response to cold testing with an ice stick and an electric pulp tester
• absence of any periapical radiolucency on radiographs, except for a widened periodontal ligament
• vital coronal pulp on access opening and ability to understand the use of pain scales

Exclusion criteria

• known allergy, sensitivity, or contraindications to any opioid or nonopioid analgesic including aspirin or NSAIDs
• history of active peptic ulcer within the preceding 12 months
• history of bleeding problems or anticoagulant use within the last month
• patients who were pregnant or breast-feeding
• a history of known or suspected drug abuse
• patients who had taken NSAIDs within 12 h before administration of the study drugs

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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120 participants in 3 patient groups

Inferior Alveolar nerve block with 2% lidocaine with epinephrine

Active Comparator group

Description:

An inferior alveolar nerve block was given with 2% lidocaine with epinephrine

Treatment:

Drug: local anaesthetic injection

Inferior Alveolar nerve block with 4% articaine with epinephrine

Experimental group

Description:

An inferior alveolar nerve block was given with 4% articaine with epinephrine

Treatment:

Drug: local anaesthetic injection

Inferior Alveolar nerve block with 3% plain mepivacaine

Experimental group

Description:

An inferior alveolar nerve block was given with 3% plain mepivacaine

Treatment:

Drug: local anaesthetic injection