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Clinical Trial
. 2021 Fall;16(4):210-216.
doi: 10.22037/iej.v16i4.33555.

The Effect of Adding Clonidine to Articaine and Epinephrine on Post-treatment Pain: A Randomized Clinical Trial Study

Elham Shadmehr  1 , Sara Hashemi  2 , Seyed Saman Hashemi  3 , Yoo Jung Chung  4 , Arman Goudarzi  3 , Abbasali Khademi  5
Affiliations
Clinical Trial

The Effect of Adding Clonidine to Articaine and Epinephrine on Post-treatment Pain: A Randomized Clinical Trial Study

Elham Shadmehr et al. Iran Endod J. 2021 Fall.

Abstract

Introduction: Articaine is reported to have a fast onset and a short-acting pulpal anesthesia in inferior alveolar nerve blocks. Clonidine is an α 2-adrenoceptor agonist and is used as an adjunct to enhance the anesthetic efficacy and induce greater analgesia. In an attempt to search for more effective ways to achieve profound analgesia after root canal treatment, this randomized clinical trial assessed the efficacy of clonidine added to articaine/epinephrine solution on post-operative pain relief after root canal treatment in mandibular molars with irreversible pulpitis.

Materials and methods: Our randomized clinical trial study enrolled one hundred patients with symptomatic irreversible pulpitis in mandibular molars. They were divided into two groups, each group received either 0.2 mL 150 µg/mL clonidine or distilled water added to 1.8 mL of 4% articaine with 1:100,000 epinephrine cartridge. The alveolar nerve block in the two groups was administered by the same clinician and the subject's pain scores were recorded at 6, 12, 24, 48 and 72 h post-operatively using a Heft-Parker visual analog scale. Data were analyzed using t, chi-square and repeated-measures ANOVA statistical tests.

Results: The mean pain scores for clonidine group were significantly lower than control at all the time intervals after treatment (P<0.05). We did not notice any clinical and there were no complaints from the patients either.

Conclusion: Based on this randomized clinical trial study the addition of clonidine to the articaine/epinephrine solution using an inferior alveolar nerve block during root canal treatment in mandibular molars with irreversible pulpitis may be effective in reducing post-operative pain.

Keywords: Articaine; Clonidine; Inferior Alveolar Nerve Block; Post-operative Pain; Root Canal Therapy.

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Conflict of interest statement

‘None declared’.

Figures

Figure 1
Figure 1
Flowchart of participants’ disposition through the trial based on CONSORT
See this image and copyright information in PMC

References

    1. Gotler M, Bar-Gil B, Ashkenazi M. Postoperative pain after root canal treatment: a prospective cohort study. Int J Dent. 2012;2012:310467. - PMC - PubMed
    1. Law AS, Durand EU, Rindal DB, Nixdorf DR. "Doctor, why does my tooth still hurt"? Northwest Dent. 2010;89(1):33–6. - PMC - PubMed
    1. Sadaf D, Ahmad MZ. Factors associated with postoperative pain in endodontic therapy. Int J Biomed Sci. 2014;10(4):243–7. - PMC - PubMed
    1. Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: a systematic review. Int Endod J. 2008;41(2):91–9. - PubMed
    1. Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, Carter T, Cassidy CL, Chittenden EH, Degenhardt E, Griffith S, Manworren R, McCarberg B, Montgomery R, Murphy J. Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17(2):131–57. - PubMed

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