مقايسه اثر ليدوكايين مرفني باليدوكايين در بي حس كردن دندان هاي انسان با پالپ آماسي

Comparative Study of Lidocaine and Lidocain-Morphine in Anesthetizing Human Inflamed Pulp

Background & Aim: Failure to obtain adequate anesthesia in teeth with inflamed pulp is one of the most common problem for general dentists and endodontists. Previous study showed opiod receptors on terminals of myelinated and unmyelinated primary afferent neurons in animal models. Opioid can produce peripheral analgesic effects by activation of opioid receptors on sensory nerves. The purpose of this study was to compare a new method of obtaining complete anesthesia in human teeth with inflamed pulp by using a combination of lidocaine and morphine and lidocaine alone. Method & Materials: One hundred patients, referring to endodontic therapy who were presenting pain on either maxillary or mandibular molars with vital pulp participated in this study. These patients were randomly divided in two groups. One group received a standard local anesthetic solutions (1,8m1 lidocaine %2 plus 1180000 epinephrine hydrochloride) and the other group received the combined solution (1mg morphine added to standard solution). All solutions were prepared in packages with similar shapes and coded for double blind study. All patients received either submucosal injection on maxillary teeth and inferior alveolar nerve block on mandibular teeth. Profound pulpal anesthesia during cavity preparation after the first and second injections was assessed. Pain intensity was evaluated by using a visual analog scale (VAS) before and 4.6.12.24 and 36 hours after R.C.T.Data were analyzed using the chi-square and Mann-Whitney tests. Results: Results showed no significant differences in establishment of adequate pulpal anesthesia after the first and second injections between the two groups. How erver, pain intensity after R.C.T. was significantly lower in lidocaine-morphine group as compared to lidocaine group at all periods. Conclusion: These findings suggest that the addition of 1mg morphine to the standard anesthetic solution significantly reduces post-operative pain intensity after R.C.T.