A double-blinded randomized trial depicted that in patients suffering from pulpitis, preoperative use of oral Ketorolac, Dexamethasone, or Prednisolone might raise the anesthetic effectiveness of inferior alveolar nerve blocks (IANB). Investigators examined the anesthetic success of IANB with 2% Lidocaine in mandibular molars having pulpitis following oral premedication with Prednisolone, Dexamethasone, and Ketorolac versus placebo.

Sixty minutes before IANB administration, Ketorolac, Dexamethasone, Prednisolone, or placebo (n=46 each) were given to 184 individuals who had been diagnosed with pulpitis in mandibular molars. Following successful confirmation of lip numbness and two consecutively negative results from the electric pulp tests, the access cavity preparation was commenced. When there was no pain experienced during endodontic access or instrumentation, the anesthesia's effectiveness was clinically proven.

Quantitative factors were compared between the groups using a one-way ANOVA test, while categorical variables were compared using chi-square tests. The relationship between preoperative medications, age, and preoperative pain was examined using binary logistic regression. IANB's success rate was reported to be 60.86%, 65.21%, 56.52%, and 21.73% when premedicated with Dexamethasone, Ketorolac, Prednisolone, and Placebo, respectively.

Prednisolone, Dexamethasone, or Ketorolac premedication considerably improved IANB's success rate when compared to placebo. But, no discernible differences were found between Ketorolac, Dexamethasone, and Prednisolone. There was only one case of gastritis in the Ketorolac group, while there were none in the Dexamethasone or Prednisolone groups.