Eur Endod J. Ahead of Print: EEJ-15010 | DOI: 10.14744/eej.2024.15010

Evaluation of the Anaesthetic Efficacies of Three Different Formulations of Intraligamentary Injections For Hypertensive Patients with Symptomatic Irreversible Pulpitis: A Randomised Controlled Trial

Meghna Kothari¹, Nimisha Chinmay Shah¹, Vasudev Ballal², Lora Mishra³, Ajay Singh Rao^1
1Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital, Gujarat, India
²Department of Conservative Dentistry and Endodontics Manipal College of Dental Sciences, Manipal Academy of Higher Education Karnataka, India
³Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences Siksha’O’ Anusandhan, Odisha, India

Objective: This double-blinded randomised clinical trial aimed to compare the efficacy of lignocaine, diclofenac sodium and ketorolac tromethamine as supplemental intraligamentary injections for intra-appointment pain in normotensive and hypertensive patients with moderate to severe symptomatic irreversible pulpitis.
Methodology: Ethical clearance was obtained, and the trial was registered on the Clinical Trial Registry India (CTRI/2020/09/027635; Registered on 07/09/2020). A total of 198 patients were divided into two groups—hypertensive group (Group 1; n=99) and normotensive (healthy) group (Group 2; n=99). After computerised randomisation and double blinding, participants were subdivided into three subgroups—1A/2A: lignocaine (n=33), 1B/2B: diclofenac sodium (n=33) and 1C/2C: ketorolac tromethamine (n=33). The preoperative visual analogue scale (VAS) scores was recorded. For the hypertensive group, blood pressure was recorded, and inferior alveolar nerve block (IANB) comprising 1.8ml of 2% lignocaine without adrenaline was administered. For the normotensive group, IANB with 1.8ml of 2% lignocaine with adrenaline was administered. A supplemental intraligamentary injection comprising one of the experimental drugs was injected to both the groups. Endodontic access was gained, and the intraoperative VAS score was recorded. As part of the statistical analysis, paired t-tests, Tukey’s post hoc test and ANOVA were performed using SPSS software version 20.
Results: Supplemental intraligamentary injections of diclofenac sodium and ketorolac tromethamine showed a statistically significant difference (p<0.05) compared to lignocaine in the reduction of intraoperative pain with no side effects in hypertensive and healthy individuals.
Conclusion: Supplemental injections of both NSAIDs performed better than lignocaine in reducing intraoperative pain among healthy and hypertensive individuals. (EEJ-2023-06-076)

Keywords: Hypertension, intraligamentary injection, intra-operative pain, ketorolac tromethamine, symptomatic irreversible pulpitis

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