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首页> 外文期刊>International endodontic journal >Effect of oral premedication on the anaesthetic efficacy of inferior alveolar nerve block in patients with irreversible pulpitis – A systematic review and network meta‐analysis of randomized controlled trials
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Effect of oral premedication on the anaesthetic efficacy of inferior alveolar nerve block in patients with irreversible pulpitis – A systematic review and network meta‐analysis of randomized controlled trials

机译：口服预留对不可逆牙髓炎患者较低肺泡神经障碍的麻醉疗效的影响 - 一种随机对照试验的系统综述与网络荟萃分析

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Abstract This systematic review ( SR ; PROSPERO database: CRD 42017075160) and network meta‐analysis ( NMA ) identified the most effective oral premedication for anaesthetic success of inferior alveolar nerve blocks ( IANB ) in cases of irreversible pulpitis. Medline and Ebscohost databases were searched up until 10/2017. Randomized controlled trials ( RCT ) studying the effect of oral premedication, alone or in combination, on the success of IANB for cases of irreversible pulpitis, compared to placebo or other oral premedications, were included. Quality of the included studies was appraised by the revised Cochrane risk of bias tool for randomized trials. Pairwise analysis, NMA and quality of evidence assessment using GRADE criteria were performed. Nineteen studies ( n ?=?1654 participants) were included. NMA demonstrated that compared to placebo, dexamethasone was most effective in increasing anaesthetic success ( RR , 2.92 [95% CI 1.74,4.91]; SUCRA ?=?0.96), followed by NSAID s ( RR , 1.92 [95% CI 1.63,2.27], SUCRA ?=?0.738) and Tramadol ( RR , 2.03 [95% CI 1.18,3.49], SUCRA ?=?0.737). Premedication with acetaminophen added to NSAID s demonstrated similar efficacy as NSAID s alone ( RR , 1.06 [95% CI 0.79,1.43]). Sensitivity analyses proved the superiority of dexamethasone or NSAID s over any other premedications. Subgroup analyses of specific dosages in comparison with placebo demonstrated that dexamethasone 0.5?mg was most effective, followed by ketorolac 10?mg, piroxicam 20?mg, ibuprofen 400?mg?+ acetaminophen 500?mg and Tramadol 50?mg. Ibuprofen 400?mg, 600?mg and 800?mg had a significantly improved IANB success, while Ibuprofen 300?mg had no effect. Oral premedication with dexamethasone, NSAID s or Tramadol significantly increased anaesthetic success. More trials are needed to evaluate the premedication effects of dexamethasone or Tramadol for improved anaesthetic success of IANB when treating irreversible pulpitis.
机译：摘要该系统评价（SR; Prospero数据库：CRD 42017075160）和网络元分析（NMA）确定了在不可逆牙髓炎的情况下，较弱的肺泡神经阻滞（IANB）麻醉成功的最有效的口腔遗传。搜索了MEDLINE和EBSCOHOST数据库，直到10/2017。包括随机对照试验（RCT）研究口服预留，单独或组合的影响，与安慰剂或其他口腔有关的IANB对IANB的成功进行疗效。所包含的研究质量被随机试验的偏置工具的经修订的Cochrane风险评估。使用等级标准进行成对分析，NMA和证据评估的质量。包括19项研究（n？=？1654名参与者）。 NMA证明与安慰剂相比，地塞米松在增加麻醉成功时最有效（RR，2.92 [95％CI 1.74.91]; SUCRA？= 0.96），其次是NSAID S（RR，1.92 [95％CI 1.63,2.27 Sucra？=β= 0.738）和曲马多（RR，2.03 [95％CI 1.18,3.49]，Sucra？= 0.737）。加入到NSAID的乙酰氨基酚的预留展示了单独的NSAID S的疗效（RR，1.06 [95％CI 0.79,1.43]）。敏感性分析证明了Dexamethasone或NSAID在任何其他前提下的优越性。与安慰剂相比，特异性剂量的亚组分析证明了0.5μg最有效的，其次是Ketorolac 10？Mg，吡洛昔康20×Mg，布洛芬400×Mg？+乙酰氨基酚500〜Mg和曲马多。布洛芬400？MG，600？MG和800？MG的IANB成功显着提高，而布洛芬300？MG没有效果。用地塞米松，NSAID或曲马多的口服预留显着增加麻醉成功。需要更多的试验来评估地塞米松或曲马多的预筛作效果，以改善IANB治疗不可逆牙髓炎的麻醉剂成功。

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