Evaluation of anesthetic efficacy of three different forulation of intraligamentary injection in hypertensive patients with symptomatic irreversible pulpitis- A randomised controlled trial

Abstract

Abstract Objective: This double blinded randomized clinical trial was aimed to compared the efficacy of supplemental intraligamentary injections of lignocaine, diclofenac sodium, and ketorolac tromethamine on intra-appointment pain in healthy and hypertensive patients with moderate to severe symptomatic irreversible pulpitis. Methodology: Ethical clearance and Clinical Trial Registry India (CTRI/2020/09/027635) was done (Registered on:07/09/2020). A total of 199 patients were divided into two groups: - Group 1- Hypertension (n=99) and Group 2-Healthy (n=99). After computer randomization and double blinding, participants were subdivided into three subgroups 1A/2A: lignocaine (n=33). 1B/2B: diclofenac sodium (n=33). Subgroup 1C/2C: ketorolac tromethamine (n=33). Pre-operative VAS was recorded. For group 1, blood pressure was recorded, and IANB with 1.8ml of 2% Lignocaine without Adrenaline was administered. For group 2, IANB with 1.8ml of 2% Lignocaine with Adrenaline was administered. Supplemental intraligamentary injection of either of experimental drugs was given. Endodontic access was gained, and an intra-operative VAS score was recorded. Statistical analysis was performed using the Paired t-test, Tukey’s Post Hoc test and ANOVA using SPSS software version 20.Results: Supplemental intraligamentry injections of Diclofenac Sodium And Ketorolac Tromethamine showed a statistically significant difference (p<0.05) than lignocaine in reduction of intraoperative pain among hypertensive and healthy individuals with no side effects.Conclusion: Supplemental injections of both NSAIDs performed better than lignocaine in reducing intra-operative pain among healthy and hypertensive individuals. Clinical Relevance: Hypertensive patient having tooth with symptomatic irreversible pulpitis is always a challenge. Supplemental intra-ligamentary injection with use of NSAIDs will reduce the intraoperative pain, side effects and can be preferred over oral pre-medications.