关键词: 塞来昔布, 超前镇痛, 不可复性牙髓炎, 下牙槽神经阻滞麻醉, 根管治疗

Abstract:

Objective To evaluate the effect and safety of celecoxib preemptive analgesia on pain during root canal treatment of mandibular posterior pulpitis. Methods Patients(n=120) with irreversible pulpitis of mandibular posterior teeth who underwent root canal treatment were randomly divided into group A as control group, group B as ibuprofen group and group C as celecoxib group. Standard oral doses of placebo, 300 mg ibuprofen, and 200 mg celecoxib were respectively given 0.5 hours before surgery. During the operation, 2% lidocaine was used for inferior alveolar nerve block anesthesia. Pulp opening, pulp extraction, root canal preparation, root canal calcium hydroxide disinfection and drug sealing were completed. The degree of pain before, during, and after treatment was evaluated using digital rating scale (NRS) 0-10, and the onset, duration, and adverse effects of anesthesia were recorded. Results All cases had different degree of pain. However, the NRS score in celeoxib group was lower than that in ibuprofen group and control group (P<0.05). There was no significant difference in NRS score between ibuprofen group and control group (P>0.05), but postoperative score of ibuprofen group was lower than control group (P<0.05). There was no significant difference in the duration of anesthesia among the three groups (P>0.05). The onset time of anesthesia in celecoxib group was shorter than that in ibuprofen group and control group (P<0.05). The onset time of anesthesia in ibuprofen group was shorter than that in control group (P<0.05). There was no significant difference in the incidence of anesthesia adverse reactions among the three groups (P>0.05). Conclusion In the root canal treatment of mandibular posterior tooth irreversible pulpitis, oral celecoxib can effectively improve the effect of inferior alveolar nerve block anesthesia, shorten the onset time of anesthesia, reduce the intraoperative and postoperative pain of patients, and do not increase the incidence of adverse reactions, which is worthy of promotion and application.

Key words: celecoxib, preemptive analgesia, irreversible pulpitis, inferior alveolar nerve block anesthesia, root canal therapy