NSAID and Nitrous Oxide Usage Preoperatively Before Local Anesthesia

In a recent systematic review with meta-analysis and trial sequential analysis by Nagendrababu et al,²⁸ it was reported that a preoperative oral dosage of ibuprofen greater than 400 mg can increase the success of local anesthesia when an IANB is used on patients with irreversible pulpitis. The report also stated that ketorolac 10 mg and diclofenac 50 mg are effective alternative premedications that have shown to increase the efficacy of IANB in patients with irreversible pulpitis. Nitrous oxide has been found to increase the success rate of local anesthesia in mandibular posterior teeth with symptomatic irreversible pulpitis.²⁹