Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Fall;14(4):247-252.
doi: 10.22037/iej.v14i2.22452.

Effect of Phentolamine as Reversal of Soft-Tissue Anesthesia on Post-Endodontic Pain in Patients with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial

Elham Shadmehr  1 , Masoud Saatchi  2 , Nima Damoon Sarmast  3 , Shervin Bagherieh  2 , Amin Davoudi  4
Affiliations

Effect of Phentolamine as Reversal of Soft-Tissue Anesthesia on Post-Endodontic Pain in Patients with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial

Elham Shadmehr et al. Iran Endod J. 2019 Fall.

Abstract

Introduction: Phentolamine mesylate (OraVerse) is mostly used to reverse soft tissue anesthesia after dental procedures. The aim of the present study was to evaluate the effect of the injection of OraVerse on postoperative pain after root canal treatment in patients with symptomatic irreversible pulpitis.

Methods and materials: In this randomized single-blind clinical trial study, 100 patients (50 per group) with symptomatic irreversible pulpitis in the first or second mandibular molars, randomly received either OraVerse or sham treatment after a single-visit root canal therapy. Each patient recorded their pain score, using a Heft Parker visual analogue scale, before and after 6, 12, 24, 36, 48, and 72 h of the treatment. They also monitored their soft-tissue anesthesia every 15 min for 5 h. Data were analyzed by t-test and repeated measured ANOVA statistical tests. The level of significance was set at 0.05.

Results: Patients who received phentolamine had significantly higher pain scores at 6- and 12-h postoperative intervals compared with those receiving sham treatment (P=0.01 and P=0.00 respectively). Consumption of analgesics in OraVerse group was significantly higher than that of the sham group (P=0.48).

Conclusion: Although phentolamine accelerated the reversal of normal soft tissue sensation after the dental visit, it increased postoperative pain in patients suffering from symptomatic irreversible pulpitis, which may limit phentolamine administration in this group.

Keywords: Anesthesia; Inferior Alveolar Nerve; Lidocaine; Phentolamine Mesylate; Postoperative Pain.

PubMed Disclaimer

Conflict of interest statement

‘None declared’.

Figures

Figure 1
Figure 1
The VAS data of the OraVerse and sham groups which illustrates the mean intensity of pain before the treatment and 6, 12, 24, 36, 48 and 72 h after endodontic treatment
Figure 2
Figure 2
The number of analgesic tablets taken by patients in the OraVerse and sham groups during the first 72 h after root canal treatment
Figure 3
Figure 3
Flowchart of the included patients into the study
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. El Mubarak AH, Abu-bakr NH, Ibrahim YE. Postoperative pain in multiple-visit and single-visit root canal treatment. J Endod. 2010;36(1):36–9. - PubMed
    1. De Oliveira GS Jr, Agarwal D, Benzon HT. Perioperative single dose ketorolac to prevent postoperative pain: a meta-analysis of randomized trials. Anesth Analg. 2012;114(2):424–33. - PubMed
    1. Nourbakhsh N, Shirani F, Babaei M. Effect of phentolamine mesylate on duration of soft tissue local anesthesia in children. J Res Pharm Pract. 2012;1(2):55–9. - PMC - PubMed
    1. Fernandez C, Reader A, Beck M, Nusstein J. A prospective, randomized, double-blind comparison of bupivacaine and lidocaine for inferior alveolar nerve blocks. J Endod. 2005;31(7):499–503. - PubMed
    1. Moore PA, Hersh EV, Papas AS, Goodson JM, Yagiela JA, Rutherford B, et al. Pharmacokinetics of lidocaine with epinephrine following local anesthesia reversal with phentolamine mesylate. Anesth Prog. 2008;55(2):40–8. - PMC - PubMed

LinkOut - more resources