The additive effect of clonidine to lidocaine on postoperative pain management after root canal treatment on mandibular molars with symptomatic irreversible pulpitis: A prospective randomised double-blind clinical trial

Elham Shadmehr; Nima D Sarmast; Amin Davoudi; Yoo J Chung; Howard H Wang

doi:10.4103/JCD.JCD_523_20

The additive effect of clonidine to lidocaine on postoperative pain management after root canal treatment on mandibular molars with symptomatic irreversible pulpitis: A prospective randomised double-blind clinical trial

J Conserv Dent. 2021 Jan-Feb;24(1):24-28. doi: 10.4103/JCD.JCD_523_20. Epub 2021 Jul 5.

Authors

Elham Shadmehr¹, Nima D Sarmast², Amin Davoudi³, Yoo J Chung¹, Howard H Wang⁴

Affiliations

¹ Department of Preventive and Restorative Dental Science, School of Dentistry, University of California, San Francisco, CA, USA.
² Department of Periodontics and Dental Hygiene, School of Dentistry at Houston, University of Texas, Houston, TX, USA.
³ Torabinejad Dental Research Center, Isfahan, Iran.
⁴ Department of Dental Medicine, New York Medical College, Valhalla, NY, USA.

Abstract

Context: Postoperative pain control has been a common challenge to clinicians in endodontics.

Aims: This double-blind randomized clinical trial assessed the efficacy of clonidine added to lidocaine for postoperative pain following endodontic treatment of mandibular molars with symptomatic irreversible pulpitis (SIP).

Methods: One hundred participants with lower molars experiencing SIP were recruited and randomly assigned to two groups. 1.8 mL of 2% lidocaine with either epinephrine (1:80,000) or clonidine (15 µg/mL) was administered to each group via an inferior alveolar nerve block. A Heft-Parker Visual Analog Scale was used to rate preoperative pain and at 6, 12, 24, 36, 48, and 72 h following endodontic treatment. Their postoperative analgesic consumption was recorded.

Statistical analysis used: The analgesic efficacy was analyzed by Chi-square test, paired t-test, and repeated measures ANOVA (P < 0.05).

Results: Early postoperative pain was significantly lower in the lidocaine/clonidine group than the lidocaine/epinephrine group (6 h: P = 0.038; 12 h: P = 0.031). The lidocaine/clonidine group consumed a significantly lower amount of analgesics (P = 0.048).

Conclusions: The administration of clonidine added to lidocaine may reduce early postoperative pain and consumption of analgesics following endodontic treatment in lower molars with SIP.

Keywords: Clonidine; inferior alveolar nerve; irreversible pulpitis; lidocaine; postoperative pain; root canal therapy.