Local Tramadol Improves the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
Study Design
3. Information Search
3.1. Population, Interventions, Control, and Outcome (PICO) Approach [31]
3.1.1. Inclusion Criteria
3.1.2. Exclusion Criteria
3.2. The Cochrane Collaboration’s Risk-of-Bias Tool
3.3. Extraction of Information
3.4. Statistical Analysis
4. Results
4.1. Search and Measurement of Bias
4.2. Qualitative Assessment
4.3. Quantitative Evaluation
4.4. The Publication Bias
5. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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ID Study and, Study Design | Treatments (n) | Details of Patients, Dental Procedure, and Evaluation | Conclusions |
---|---|---|---|
Aksoy and Ege, 2020a [13]. Randomized, double-blind, parallel, clinical study. | Group A: Tramadol 100 mg (n = 35). Group B: Lidocaine 40 mg (n = 35). Group C: Normal saline (n = 35). All treatments were given (2 mL volume) across the mucobuccal fold of the mandibular molar. | Patients aged 18 to 60 years with symptomatic irreversible pulpitis diagnosis (moderate to severe pain) and, without periapical radiolucency on radiography at a mandibular molar were included. Patients without analgesic medication, at least, 24 h before the study. Positive Endo Ice F cold tests. A standard cartridge with 1.8 mL 2% lidocaine with 1:80,000 epinephrine was administered via the IANB route. Anesthesia was successful when the pain level of patients was no pain or mild pain. The anesthesia success rate and adverse effects were evaluated. | The results did not show any statistical difference between groups. |
Aksoy and Ege, 2020b [14]. Randomized, double-blind, parallel, clinical trial. | Group A: Tramadol 100 mg (n = 30). Group B: Dexamethasone 8 mg (n = 30). Group C: Normal saline (n = 30). All treatments were given (2 mL volume) across the mucobuccal fold of the mandibular molar. | Healthy patients aged 18 to 65 years old with a diagnosis of symptomatic irreversible pulpitis (moderate to severe pain) in a mandibular molar, radiographically normal periapical area, and no pain on percussion were included. Patients without analgesic medication, at least, 12 h before the study. Positive Endo Ice F cold tests. An IANB using 4% articaine with 1:200,000 epinephrine was used. Postoperative pain intensity, rescue analgesic medication, and adverse effects were evaluated. | Submucosal tramadol was most effective for pain control when compared to saline. |
Aksoy et al., 2021 [15]. Randomized, double-blind, parallel, clinical assay. | Group A: Tramadol 100 mg (n = 30). Group B: Dexamethasone 8 mg (n = 30). Group C: Articaine 4% (n = 30). Group D: Normal saline (n = 30). All treatments were given (2 mL volume) across the mucobuccal fold of the mandibular molar. | Healthy patients aged 18 to 65 years old with a diagnosis of symptomatic irreversible pulpitis (moderate to severe pain) in a mandibular molar, radiographically normal periapical area, and no pain on percussion were included. Patients without analgesic medication, at least, 24 h before the study. Positive Endo Ice F cold tests. An IANB using 4% articaine with 1:200,000 epinephrine was used. Anesthesia was successful when the pain level of patients was no pain or mild pain. Sensory blockade, duration of anesthesia, anesthetic success index, and adverse effects were assessed. | Submucosal articaine increased the success anesthesia rate and dexamethasone the duration of the anesthetic activity when compared to saline in patients with symptomatic irreversible pulpitis. |
De Pedro-Muñoz and Mena-Álvarez, 2017 [16]. Randomized, double-blind, parallel, clinical investigation. | Group A: Tramadol 50 mg (n = 21). Group B: Normal saline (n = 21). All treatments were given (1 mL volume) across the mucobuccal fold of the mandibular molar. | Patients aged 18 to 64 years with symptomatic irreversible pulpitis diagnosis in a mandibular molar. Patients without analgesic medication, at least, 24 h before the study. Positive Endo Ice F cold tests. A standard cartridge with 1.8 mL 4% articaine with 1:100,000 epinephrine was administered via the IANB route. The access cavity, the anesthesia success rate, and adverse effects were evaluated. | Submucosal administration of tramadol increased the success rate of access cavity in patients with symptomatic irreversible pulpitis. |
Mehrvarzfar et al., 2017 [18]. Randomized, double-blind, parallel, clinical study. | Group A: Tramadol 100 mg (n = 24). Group B: Acetaminophen 375 mg (n = 23). Group C: Naproxen 500 mg (n = 24). Group D: Placebo (n = 24). All treatments were administered orally. | Patients aged 20 and 60 years old without systemic illness and, no pregnant women. Patients without analgesic medication, at least, 12 h before the study. Anesthesia was done using 1 cartridge of lidocaine and adrenaline 1:80,000. Pain intensity was assessed pre-operatively, and at 6, 12, and 24 h. Adverse effects were not evaluated. | Tramadol was more effective for pain control after root channel therapy. |
Rodríguez-Wong et al., 2016 [17]. Randomized, double-blind, parallel, clinical trial. | Group A: A cartridge with 1.3 mL of 2% mepivacaine with epinephrine 1:100 000 plus 0.5 mL of tramadol 25 mg/mL (n = 28). Group B: A cartridge with 1.8 mL of 2% mepivacaine with epinephrine 1:100 000 (n = 28). All treatments were given (1.8 mL volume) across the mucobuccal fold of the mandibular molar. | Patients aged 18 years or older with symptomatic irreversible pulpitis in a mandibular molar. Patients without analgesic medication, at least, 12 h before the study. Positive Endo Ice F cold tests. The IANB was performed according to the information of treatment groups. Anesthesia was successful when the pain level of patients was no pain or mild pain. Sensory blockade, duration of anesthesia, anesthetic success index, and adverse effects were assessed. | There was no statistical difference between treatment groups. |
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Gómez-Sánchez, E.; Franco-de la Torre, L.; Bologna-Molina, R.E.; Molina-Frechero, N.; Serafín-Higuera, N.A.; Hernández-Gómez, A.; Alonso-Castro, Á.J.; Sat-Muñoz, D.; Isiordia-Espinoza, M.A. Local Tramadol Improves the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis. Healthcare 2022, 10, 1867. https://doi.org/10.3390/healthcare10101867
Gómez-Sánchez E, Franco-de la Torre L, Bologna-Molina RE, Molina-Frechero N, Serafín-Higuera NA, Hernández-Gómez A, Alonso-Castro ÁJ, Sat-Muñoz D, Isiordia-Espinoza MA. Local Tramadol Improves the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis. Healthcare. 2022; 10(10):1867. https://doi.org/10.3390/healthcare10101867
Chicago/Turabian StyleGómez-Sánchez, Eduardo, Lorenzo Franco-de la Torre, Ronell Eduardo Bologna-Molina, Nelly Molina-Frechero, Nicolás Addiel Serafín-Higuera, Adriana Hernández-Gómez, Ángel Josabad Alonso-Castro, Daniel Sat-Muñoz, and Mario Alberto Isiordia-Espinoza. 2022. "Local Tramadol Improves the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis" Healthcare 10, no. 10: 1867. https://doi.org/10.3390/healthcare10101867