In individuals with symptomatic irreversible pulpitis, the local use of Tramadol improves the anesthetic success index when compared to placebo.

This systematic review and meta-analysis was carried out to assess the effectiveness of Tramadol pre-treatment in patients with pulpitis, along with for pain management and side effects.

To find clinical studies comparing Tramadol and placebo/local anaesthetics in patients with pulpitis, PubMed was examined. Extraction of the data on the anesthetic, pain management, and negative effects was done. The Mantel-Haenszel test and odds ratio (OR) were used to compare the anaesthetic success index and the side effects of local Tramadol versus placebo.

In patients with irreversible pulpitis, local Tramadol treatment enhanced the anesthetic success rate when compared to placebo (n = 228; I2 = 0; OR = 2.2), according to data analysis. Contrary to local anesthetics/placebo, Tramadol local administration increased the likelihood of side effects (n = 288; I2 = 0; OR = 7.72).

In comparison with placebo or local anaesthetics, submucosal Tramadol injection enhanced the anesthetic success rate with negligible side effects in patients with symptomatic irreversible pulpitis receiving root channel therapy.