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

Study Overview
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Brief Summary
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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.

Official Title
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Comparative Evaluation of Pulpal Anaesthetic Efficacy of Different Anaesthetic Solutions for Inferior Alveolar Nerve Block in Patients With Symptomatic Irreversible Pulpitis: a Randomized Double-blind Study

Conditions
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Pulpitis

Intervention / Treatment
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* Drug: local anaesthetic injection


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Inferior Alveolar nerve block with 2% lidocaine with epinephrine<br>An inferior alveolar nerve block was given with 2% lidocaine with epinephrine | Drug: local anaesthetic injection<br>* Inferior alveolar nerve block<br>|
| Experimental: Inferior Alveolar nerve block with 4% articaine with epinephrine<br>An inferior alveolar nerve block was given with 4% articaine with epinephrine | Drug: local anaesthetic injection<br>* Inferior alveolar nerve block<br>|
| Experimental: Inferior Alveolar nerve block with 3% plain mepivacaine<br>An inferior alveolar nerve block was given with 3% plain mepivacaine | Drug: local anaesthetic injection<br>* Inferior alveolar nerve block<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anesthetic Success | Pain during the endodontic treatment was assessed using a visual analog scale (Heft-Parker VAS). Success was defined as no or mild pain (pain score≤54mm on Hp VAS) during access preparation and root canal instrumentation. | 15 minutes after the inferior alveolar nerve block |