Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: Jan 01, 2015

Effect of Preoperative Pain on Inferior Alveolar Nerve Block

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Page Range: 135 – 139
DOI: 10.2344/15-00019.1
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The present study tested the hypothesis that the amount and severity of preoperative pain will affect the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. One-hundred seventy-seven adult volunteer subjects, actively experiencing pain in a mandibular molar, participated in this prospective double-blind study carried out at 2 different centers. The patients were classified into 3 groups on the basis of severity of preoperative pain: mild, 1–54 mm on the Heft-Parker visual analog scale (HP VAS); moderate, 55–114 mm; and severe, greater than 114 mm. After IANB with 1.8 mL of 2% lidocaine, endodontic access preparation was initiated. Pain during treatment was recorded using the HP VAS. The primary outcome measure was the ability to undertake pulp access and canal instrumentation with no or mild pain. The success rates were statistically analyzed by multiple logistic regression test. There was a significant difference between the mild and severe preoperative pain group (P = .03). There was a positive correlation between the values of preoperative and intraoperative pain (r = .2 and .4 at 2 centers). The amount of preoperative pain can affect the anesthetic success rates of IANB in patients with symptomatic irreversible pulpitis.

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Copyright: © 2015 by the American Dental Society of Anesthesiology

Linear correlation chart between Heft-Parker visual analog scale value of preoperative pain and intraoperative pain. (a) Center SGT (r = .2). (b) Center SB (r = .4).


Contributor Notes

Address correspondence to Dr Vivek Aggarwal, Department of Conservative Dentistry & Endodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India 110024; drvivekaggarwal@gmail.com.
Received: Apr 20, 2015
Accepted: Jun 22, 2015