Effect of fentanyl on the success of inferioralveolar nerve block for teeth withsymptomatic irreversible pulpitis: Arandomized clinical trial

Aim: The purpose of this prospective, randomized, double-blind studywas toevaluate the effect of adding fentanyl to lidocaine ۲% with epinephrine۱:۸۰,۰۰۰on the success of the inferior alveolar nerve block in mandibular molarteethwith symptomatic irreversible pulpitis.Methodology: ۱۰۰ healthy adult patients with diagnosis of symptomaticirreversible pulpitis in one of the mandibular molar tooth were selectedandrandomly divided in two groups of ۵۰ patients each. In the frst group(fentanylgroup), ۰.۲۵ ml of a cartridge of ۱.۸ ml of ۲% lidocaine with ۱:۸۰,۰۰۰epinephrine solution was drained and the same amount from ۵۰μg/ mlfentanylsolution was added to the cartridge. In the second group (non-fentanylgroup)۰.۲۵ ml of a cartridge of ۱.۸ ml of ۲% lidocaine with ۱:۸۰,۰۰۰epinephrinesolution was drained and the same amount from saline solution wasaddedto the cartridge. Each group received two cartridges of preparedsoloutionwith inferior alveolar nerve block injection technique. Access cavity preparation started ۱۵ minautes after injection and after confrming the lip numbness. Success defned as no pain or mild pain on the basis of Heft-Parker visual analog scale during access cavity preparation or initial instrumentation. Data were analyzed by T-test and Chi-square Results: The success rate of inferior alveolar nerve block injection was ۵۸% for Fentanyl group and ۴۶% for Non-Fentanyl group. There was no signifcant difference between the two groups (P=۰.۲۳). Conclusions: The addition of fentanyl to lidocaine ۲% with epinephrine ۱:۸۰,۰۰۰ did not increase the success rate of the inferior alveolar nerve block in mandibular molar teeth with symptomatic irreversible pulpitis.