Effect Of Prophylactically Administered Ketorolac And Diclofenac Potassium On The Efficacy Of Inferior Alveolar Nerve Block In Patients With Symptomatic Irreversible Pulpitis, Double-Blind Randomized Control Trial.

BackgroundInferior alveolar nerve block is the most frequently used local anesthetic agent, administered to achieve regional anesthesia for root canal treatment, however, in cases of irreversible pulpitis, there may be anesthetic resistance. To overcome this issue, many conservative and invasive supplementary procedures are introduced to increase the efficacy of nerve block, including prophylactic use of orally administered NSAIDs. ObjectiveTo compare the effect of prophylactically administered Ketorolac and Diclofenac Potassium on the efficacy of inferior alveolar nerve block in patients presenting with symptomatic irreversible pulpitis. MethodologyThis double-blind study included a total number of 130 patients with a diagnosis of symptomatic irreversible pulpitis which was confirmed with a cold test. Before initiating the treatment, the patients were asked to rate their pain on a VAS with pain divided into four categories, no pain, mild pain, moderate pain, and severe pain. 10 mg Ketorolac and 50 mg Diclofenac potassium were equally divided into two groups and 1 tablet of each was orally administered to patients 1 hour before initiating root canal treatment. IANB was given and a root canal procedure was initiated under full aseptic protocol. The pain score was recorded on VAS during endodontic access preparation and root canal instrumentation. Data was analyzed through cross-tabulation and the Chi-square test was applied. (P value = 0.05) ResultsThe comparison of prophylactically administered ketorolac and diclofenac potassium on the efficacy of inferior alveolar nerve block depicted the success rate was 64.6% in Ketorolac group as compared to 43.1% in Diclofenac potassium group. ConclusionOral premedication with NSAIDs can improve the efficacy of Inferior alveolar nerve block in a non-invasive manner with better results yielded with the use of orally administered Ketorolac as compared to Diclofenac Potassium.