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Background@#The efficacy of local anesthesia decreases in patients with symptomatic irreversible pulpitis. Therefore, it was proposed that the use of premedication with an anti-inflammatory drug might increase the success rate of pulpal anesthesia in mandibular posterior teeth with vital inflamed pulp. @*Methods@#One hundred thirty-four patients who were actively experiencing pain willingly participated in this study. The Heft Parker (HP) visual analog scale (VAS) was used to record the initial pain intensity. Patients were randomly allocated to receive a placebo, 10 mg of ketorolac, and 650 mg of paracetamol. The standard inferior alveolar nerve block (IANB) was administered to all patients using 2% lidocaine with 1:200,000 adrenaline after one hour of medication. After 15 min, the patient was instructed to rate the discomfort during each step of the treatment procedure, such as access to remaining dentin, access to the pulp chamber, and during canal instrumentation on the HP VAS. IANB was considered successful if the patient reported no or mild pain during access preparation and instrumentation. Moderate or severe pain was classified as a failure of IANB and another method of anesthesia was used before continuing the treatment. @*Results@#The rate of successful anesthesia in the placebo, paracetamol, and ketorolac groups was 29%, 33%, and 43%, respectively, and no statistically significant difference was found between the groups. @*Conclusion@#Preoperative administration of paracetamol or ketorolac did not significantly affect the success rate of IANB in patients with irreversible pulpitis. No significant difference was observed between the paracetamol and ketorolac groups.
RESUMO
Background@#The efficacy of local anesthesia decreases in patients with symptomatic irreversible pulpitis. Therefore, it was proposed that the use of premedication with an anti-inflammatory drug might increase the success rate of pulpal anesthesia in mandibular posterior teeth with vital inflamed pulp. @*Methods@#One hundred thirty-four patients who were actively experiencing pain willingly participated in this study. The Heft Parker (HP) visual analog scale (VAS) was used to record the initial pain intensity. Patients were randomly allocated to receive a placebo, 10 mg of ketorolac, and 650 mg of paracetamol. The standard inferior alveolar nerve block (IANB) was administered to all patients using 2% lidocaine with 1:200,000 adrenaline after one hour of medication. After 15 min, the patient was instructed to rate the discomfort during each step of the treatment procedure, such as access to remaining dentin, access to the pulp chamber, and during canal instrumentation on the HP VAS. IANB was considered successful if the patient reported no or mild pain during access preparation and instrumentation. Moderate or severe pain was classified as a failure of IANB and another method of anesthesia was used before continuing the treatment. @*Results@#The rate of successful anesthesia in the placebo, paracetamol, and ketorolac groups was 29%, 33%, and 43%, respectively, and no statistically significant difference was found between the groups. @*Conclusion@#Preoperative administration of paracetamol or ketorolac did not significantly affect the success rate of IANB in patients with irreversible pulpitis. No significant difference was observed between the paracetamol and ketorolac groups.
RESUMO
Background: Labor induction is one of the most frequentprocedures in obstetrics. Several Meta analyses, systematicreviews and randomised controlled trials have assessed thesafety and efficacy of misoprostol as a cervical ripening andinducing agent and have come out with varied opinions.Hence; the present study was undertaken for assessing theefficacy of misoprostol as an inducing agent.Materials & Methods: A total of 30 women were enrolled inthe present study. Only those subjects were enrolled whorequired induction of labour. Clinical examination of all thepatients was carried out and detailed clinical history wasobtained. This was followed by a thorough obstetricexamination. All the subjects received misoprostol tablet 25µgevery 4 hourly intravaginally upto a maximum of 5 doses.Intravenous Oxytocin was administered as and when required.Cases in which the subject failed to enter the active phase oflabour after 24 hours of starting of induction were regarded asfailure of induction.Results: The most common indication of labour induction waspost-dated pregnancy with 11 subjects (36.66%) in themisoprostol group being of post-dated pregnancy. The nextmost common indication for labor induction was Pregnancyinduced hypertension. Fourteen women in the Misoprostolgroup delivered in less than 12 hours. Thus, the vaginaldelivery rates within 12 hours were 66.67% in the Misoprostolgroup. The mean induction to delivery interval in themisoprostol group was 10.40 hours.Conclusion: Misoprostol is an effective method of induction oflabour and is a well-tolerated drug.