Efficacy of premedication to prevent postoperative pain in people having irreversible pulpitis

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Created On: 21/02/2022

A systematic review and meta-analysis were carried out to investigate the impact of premedication on postsurgery pain following root canal therapy in the vital teeth.

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Key take away

In people having irreversible pulpitis and scheduled to undergo root canal treatment, preoperative administration of anti-inflammatory agents is an effective modality to decrease post-surgery pain for up to 24 hours.

Background

A systematic review and meta-analysis were carried out to investigate the impact of premedication on postsurgery pain following root canal therapy in the vital teeth.

Method

A total of 5 electronic databases (Google Scholar, PubMed, LILACS, Cochrane Library, TRIP) were explored to find the relevant randomized clinical trials. Selection of eligible studies and extraction of data was carried out by 2 reviewers. With the aid of Cochrane risk of bias tool, quality of studies was evaluated. Utilizing a random-effects model, meta-analysis was performed. Calculation of pooled effect estimate of standardized mean difference (SMD) between placebo and premedication was done.

On the basis of class and route of the drug, the subgroup assessment was carried out. Those studies which had an elevated risk of bias were eliminated from the sensitivity assessment. A total of 10 trials fulfilled the inclusion criteria of the study. Out of 10 trials, 8 trials were incorporated in the meta-analysis.

Result

When compared to placebo, premedication showed superior efficacy in alleviating postsurgery pain at six hours (SMD = -1.00), twelve hours (SMD = -0.80), and twenty-four hours (SMD = -0.72). This diminished pain might also aid to attenuate the occurrence of adverse effects that might be linked with repeated consumption of postsurgery analgesic drugs. The outcomes of the sensitivity analysis verified the outcomes of the primary assessment.

Conclusion

In individuals suffering from irreversible pulpitis, premedication remarkably minimized postoperative pain when compared to placebo or control at all the time intervals. But for further validation, additional high quality and robust research are warranted.