Effect of preoperative oral medication of Diclofenac sodium, Ibuprofen and Etoricoxib on the effectiveness of maxillary infiltration anaesthesia in patients with irreversible pulpitis: A Randomized Clinical Study

Abstract

Introduction Preoperative pain of endodontic origin, has its effect on the patient‘s attitude towards the endodontic treatment. Dental anxiety associated with the above may cause ineffective anaesthesia of the tissues of interest. To assess the efficacy of preoperative oral single-dose administration of three non-steroidal anti-inflammatory drugs namely, Diclofenac sodium 50 mg, Ibuprofen 200 mg and Etoricoxib 60 mg and on the effectiveness of infiltration anaesthesia in patients with irreversible pulpitis of maxillary first molars. Material and Methods Sixty (n=60) patients with a chief complaint of moderate to severe pain of endodontic origin participated in the study. Patients were asked to indicate their pain scores on a visual analog scale (VAS) and then they were divided into three groups of n=20. Then according to their groups, the patients received a single dose of Diclofenac sodium 50 mg, Ibuprofen 200 mg and Etoricoxib 60 mg one hour before administration of the infiltration anaesthesia with 2% lignocaine containing 1:80,000 epinephrine. The patients indicated their pain score on VAS after one hour of drug administration and again after completion of the access opening. Differences in the pain scores at these three intervals were noted. Data was collected and analyzed using SPSS v.20 software and subjected to descriptive statistics, one-sample t-test and one-way ANOVA test with the acceptance level of significance set at p<0.05. Results Diclofenac sodium 50 mg, Ibuprofen 200 mg and Etoricoxib 60 mg had shown a gradual decrease in mean pain scores after the completion of access opening, which was statistically significant (p<0.05). Etoricoxib 60 mg (p=0.01) showed lower mean pain scores compared to Diclofenac sodium 50 mg and Ibuprofen 200 mg. Conclusion Within the limitations of the present study, Etoricoxib significantly lower mean pain scores when compared with the other two groups. Key Words Drug efficacy, Non-steroidal anti-inflammatory drugs, Visual Analog