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Local Tramadol Improves the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis

Symptomatic irreversible pulpitis is a painful clinical condition with a broad inflammatory component. Dental anesthesia in these patients is affected by the inflammatory process, reporting a high incidence of anesthesia failure. The aim of this systematic review and meta-analytical evaluation was t...

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Glavni avtor: Gómez Sánchez, Eduardo (author)
Drugi avtorji: Franco de la Torre, Lorenzo (author), Bologna-Molina, Ronell (author), Molina-Frechero, Nelly (author), Serafín-Higuera, Nicolás (author), Hernández Gómez, Adriana (author), Alonso Castro, Ángel Josabad (author), Sat Muñoz, Daniel (author), Isiordia-Espinoza, Mario Alberto (author)
Format: article
Jezik:angleščina
Izdano: 2022
Teme:
Tramadol
Symptomatic irreversible pulpitis
Anesthesia success rate
Pain control
Adverse effects
PULPITIS
TRAMADOL
ANESTESIA DENTAL
MANEJO DEL DOLOR
Online dostop:https://hdl.handle.net/20.500.12008/34081
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Izvleček:Symptomatic irreversible pulpitis is a painful clinical condition with a broad inflammatory component. Dental anesthesia in these patients is affected by the inflammatory process, reporting a high incidence of anesthesia failure. The aim of this systematic review and meta-analytical evaluation was to determine the effect of pre-treatment with tramadol in patients with symptomatic irreversible pulpitis, as well as for pain control and adverse effects. This study was registered in PROSPERO (ID: CRD42021279262). PubMed was consulted to identify clinical investigations comparing tramadol and placebo/local anesthetics in patients with symptomatic irreversible pulpitis. Data about the anesthesia, pain control, and adverse effects were extracted. Both the anesthetic success index and the adverse effects of local tramadol and placebo were compared with the Mantel–Haenszel test and odds ratio. Data analysis showed that the local administration of tramadol increased the anesthetic success rate when compared to placebo in patients with symptomatic irreversible pulpitis (n = 228; I2 = 0; OR = 2.2; 95% CIs: 1.30 to 3.79; p < 0.004). However, local administration of tramadol increased the risk of adverse effects when compared to placebo/local anesthetics (n = 288; I2 = 0; OR = 7.72; 95% CIs: 1.37 to 43.46; p < 0.02). In conclusion, this study shows that the local administration of tramadol increases the anesthetic success index when compared to placebo in patients with symptomatic irreversible pulpitis.

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