Abstract
The aim of the present study is to compare the efficacy of additional 100 mg/2 ml tramadol and 40 mg/2 ml lidocaine applications on the anesthetic success of inferior alveolar nerve block (IANB) in mandibular molars with symptomatic irreversible pulpitis (MM-SIP). One hundred and five patients diagnosed with symptomatic pulpitis in the lower first or second molars were included in the study. Patients were randomly divided into three groups (n = 35) composed of control and two experimental groups administered submucosal tramadol and lidocaine. Preoperative pain levels of the patients were measured with Heft-Parker visual analog scale (HP VAS). Following, standard IANB with 2% lidocaine 1: 80,000 was administrated to all groups. After observation of lip numbness, 2 ml of saline in the control group, 100 mg/2 ml tramadol in tramadol group and 40 mg/2 ml (2%, 1: 80,000) lidocaine in lidocaine group were administered submucosally. After 15 min, standard endodontic treatment was initiated and the pain levels measured from access cavity preparation to pulp extirpation were measured with HP VAS. The success rate of pulpal anesthesia was 28.5% in the control group, 45.7% in the submucosal lidocaine group and 48.6% in the tramadol group. There was no statistically significant difference in the success rate between the groups. Additional submucosal administration of 100 mg tramadol did not significantly increase the success of IANB applied with a combination of 2% lidocaine 1:80,000 and epinephrine in MM-SIP compared to control group.
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References
Palti DG, Almeida CM, Rodrigues Ade C, Andreo JC, Lima JE. Anesthetic technique for inferior alveolar nerve block: a new approach. J Appl Oral Sci. 2011;19:11–5.
Poorni S, Veniashok B, Senthilkumar AD, Indira R, Ramachandran S. Anesthetic efficacy of four percent articaine for pulpal anesthesia by using inferior alveolar nerve block and buccal infiltration techniques in patients with irreversible pulpitis: a prospective randomized double-blind clinical trial. J Endod. 2011;37:1603–7.
Claffey E, Reader A, Nusstein J, Beck M, Weaver J. Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with irreversible pulpitis. J Endod. 2004;30:568–71.
Hargreaves KM, Keiser K. Local anesthetic failure in endodontics. Endod Top. 2002;1:26–39.
Khalil H. A basic review on the inferior alveolar nerve block techniques. Anesth Essays Res. 2014;8:3–8.
Thangavelu K, Kannan R, Kumar NS, Rethish E, Sabitha S, Sayeeganesh N. Significance of localization of mandibular foramen in an inferior alveolar nerve block. J Nat Sci Biol Med. 2012;3:156–60.
Thangavelu K, Kannan R, Senthil KN. Inferior alveolar nerve block: Alternative technique. Anesth Essays Res. 2012;6:53–7.
Boonsiriseth K, Sirintawat N, Arunakul K, Wongsirichat N. Comparative study of the novel and conventional injection approach for inferior alveolar nerve block. Int J Oral Maxillofac Surg. 2013;42:852–6.
Aggarwal V, Singla M, Rizvi A, Miglani S. Comparative evaluation of local infiltration of articaine, articaine plus ketorolac, and dexamethasone on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis. J Endod. 2011;37:445–9.
Yadav M, Grewal MS, Grewal S, Deshwal P. Comparison of preoperative oral ketorolac on anesthetic efficacy of inferior alveolar nerve block and buccal and lingual infiltration with articaine and lidocaine in patients with irreversible pulpitis: a prospective, randomized, controlled, double-blind study. J Endod. 2015;41:1773–7.
Mohajeri L, Salehi F, Mehrvarzfar P, Arfaee H, Bohluli B, Hamedy R. Anesthetic efficacy of meperidine in teeth with symptomatic irreversible pulpitis. Anesth Prog. 2015;62:14–9.
Elsharrawy EA, Elbaghdady YM. A double-blind comparison of a supplemental interligamentary injection of fentanyl and mepivacaine with 1:200,000 epinephrine for irreversible pulpitis. J Pain Symptom Manag. 2007;33:203–7.
Grond S, Sablotzki A. Clinical pharmacology of tramadol. Clin Pharmacokinet. 2004;43:879–923.
Pozos AJ, Martinez R, Aguirre P, Perez J. The effects of tramadol added to articaine on anesthesia duration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:614–7.
Isiordia-Espinoza MA, Orozco-Solis M, Tobias-Azua FJ, Méndez-Gutiérrez EP. Submucous tramadol increases the anesthetic efficacy of mepivacaine with epinephrine in inferior alveolar nerve block. Br J Oral Maxillofac Surg. 2012;50:157–60.
Pang WW, Mok MS, Chang DP, Huang MH. Local anesthetic effect of tramadol, metoclopramide, and lidocaine following intradermal injection. Reg Anesth Pain Med. 1998;23:580–3.
Altunkaya H, Ozer Y, Kargi E, Babuccu O. Comparison of local anaesthetic effects of tramadol with prilocaine for minor surgical procedure. Br J Anaesth. 2003;90:320–2.
Mert T, Gunes Y, Guven M, Gunay I, Ozcengiz D. Comparison of nerve conduction blocks by an opioid and a local anesthetic. Eur J Pharmacol. 2002;439:77–81.
Ege B, Calisir M, Al-Haideri Y, Ege M, Gungormus M. Comparison of local anesthetic efficiency of tramadol hydrochloride and lidocaine hydrochloride. J Oral Maxillofac Surg. 2018;76:744–51.
De Pedro-Munoz A, Mena-Alvarez J. The effect of preoperative submucosal administration of tramadol on the success rate of inferior alveolar nerve block on mandibular molars with symptomatic irreversible pulpitis: a randomized, double-blind placebo-controlled clinical trial. Int Endod J. 2017;50:1134–42.
Alsandook TA, Al-Haideri YA. A pilot double clinical trial to compare between tramadol HCl and lidocaine HCl as local anesthesia amongst hospital-outpatient adult dental attendees Mosul-Iraqi. J Oral Res. 2013;1:13–6.
Al-Haideri YA. Comparison of local anesthetic efficacy of tramadol hydrochloride (with adrenaline) versus plain tramadol hydrochloride in the extraction of upper molar teeth. J Oral Maxillofac Surg. 2013;71:2035–8.
Rodríguez-Wong L, Pozos-Guillen A, Silva-Herzog D, Chavarría-Bolaños D. Efficacy of mepivacaine-tramadol combination on the success of inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis: a randomized clinical trial. Int Endod J. 2016;49:325–33.
Aggarwal V, Jain A, Debipada K. Anesthetic efficacy of supplemental buccal and lingual infiltrations of articaine and lidocaine following an inferior alveolar nerve block in patients with irreversible pulpitis. J Endod. 2009;35:925–9.
Malamed SF. Handbook of local anesthesia. 4th ed. St Louis: Mosby; 1997.
Ueno T, Tsuchiya H, Mizogami M, Takakura K. Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite. J Inflamm Res. 2008;1:41–8.
Varvara G, Bernardi S, Cutilli T, Bianchi S, Sinjari B, Piattelli M. Anti-inflammatory steroid use in impacted third molar surgery: a systematic review. J Biol Regul Homeost Agents. 2017;31:1095–9.
Marshall JG, Liesinger AW. Factors associated with endodontic posttreatment pain. J Endod. 1993;19:573–5.
Stenholm E, Bongenhielm U, Ahlquist M, Fried K. VRl- and VRL-l-like immunoreactivity in normal and injured trigeminal dental primary sensory neurons of the rat. Acta Odontol Scand. 2002;60:72–9.
Reisman D, Reader A, Nist R, Beck M, Weaver J. Anesthetic efficacy of the supplemental intraosseous injection of 3% mepivacaine in irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;84:676–82.
Nusstein J, Reader A, Nist R, Beck M, Meyers WJ. Anesthetic efficacy of the supplemental intraosseous injection of 2% lidocaine with 1:100,000 epinephrine in irreversible pulpitis. J Endod. 1998;24:487–91.
Rogers BS, Botero TM, McDonald NJ, Gardner RJ, Peters MC. Efficacy of articaine versus lidocaine as a supplemental buccal infiltration in mandibular molars with irreversible pulpitis: a prospective, randomized, double-blind study. J Endod. 2014;40:753–8.
Haeseler G, Foadi N, Ahrens J, Dengler R, Hecker H, Leuwer M. Tramadol, fentanyl and sufentanil but not morphine block voltage-operated sodium channels. Pain. 2006;126:234–44.
Kokki H, Wennervirta J, Laisalmi M, Vakkuri A. Regular tramadol use does not affect the propofol dose requirement for induction of anaesthesia. Eur J Anaesthesiol. 2007;24:776–81.
Kakagia D, Vogiatzaki T, Eleftheriadis S, Trypsiannis G, Iatrou C. Local infiltrative anesthetic effect of tramadol compared to lidocaine for excision of cutaneous lesions: pilot randomized, double-blind clinical study. J Cutan Med Surg. 2012;16:101–6.
Sarsu S, Mizrak A, Karakurum G. Tramadol use for axillary brachial plexus blockade. J Surg Res. 2011;165:e23–e2727.
Ceccheti MM, Negrato GV, Peres MP, Deboni MC, Naclério-Homem MG. Analgesic and adjuvant anesthetic effect of submucosal tramadol after mandibular third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;117:249–54.
Fullmer S, Drum M, Reader A, Nusstein J, Beck M. Effect of preoperative acetaminophen/hydrocodone on the efficacy of the inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a prospective, randomized, double-blind, placebo-controlled study. J Endod. 2014;40:1–5.
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The authors have no financial affiliation and the study has no financial support. This clinical trial was registered at www.clinicaltrials.in.th and TCTR identification number is 20190509004. We would like to thank Dr.Fatih Uckardes for his special assistance in statistical analysis.
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Aksoy, F., Ege, B. Efficacy of submucosal tramadol and lidocaine on success rate of inferior alveolar nerve block in mandibular molars with symptomatic irreversible pulpitis. Odontology 108, 433–440 (2020). https://doi.org/10.1007/s10266-020-00485-0
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DOI: https://doi.org/10.1007/s10266-020-00485-0