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Abstract
A randomized clinical trial to assess the anesthetic efficacy and the postoperative pain on using bupivacaine alone or with the addition of mannitol for inferior alveolar nerve block in patients with symptomatic irreversible pulpitis in mandibular molar teeth after single-visit root canal treatment. Sixty medically-free participants suffering from symptomatic irreversible pulpitis in mandibular molars were randomly assigned into two equal groups, according to the received local anesthesia, either bupivacaine plus mannitol group (1.8 ml of 0.5% bupivacaine with 1:200,000 epinephrine plus 1.5 ml of 20% mannitol) or bupivacaine only (1.8 ml of 0.5% bupivacaine with 1 : 200,000 epinephrine. Root canal treatment was completed in a single-visit and the pain during access cavity preparation and pulpectomy was assessed using numerical rating scale (NRS). Postoperative pain was assessed after 6, 12, 24, 48, 72 hours by using NRS. Lip numbness onset and duration and number of consumed analgesic tablets were recorded by the participants. Results showed that there is no statistically significant difference in the pain during access cavity preparation and pulpectomy between the two groups. The postoperative pain after 6 hours was significantly higher with the addition of mannitol. At 12, 24, 48, 72 hours postoperatively there was no significant difference between the two groups. The duration of lip numbness was less with the addition of mannitol. No side effects were reported for any of the medications used