Does acetaminophen/hydrocodone affect cold pulpal testing in patients with symptomatic irreversible pulpitis? A prospective, randomized, double-blind, placebo-controlled study.

Abstract

INTRODUCTION:

The purpose of this prospective randomized, double-blind, placebo-controlled study was to determine the effects of a combination dose of 1000 mg acetaminophen/10 mg hydrocodone on cold pulpal testing in patients experiencing symptomatic irreversible pulpitis.

METHODS:

One hundred emergency patients in moderate to severe pain diagnosed with symptomatic irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, identical capsules of either a combination of 1000 mg acetaminophen/10 hydrocodone or placebo. Cold testing with Endo-Ice (1,1,1,2 tetrafluoroethane; Hygenic Corp, Akron, OH) was performed at baseline and every 10 minutes for 60 minutes. Pain to cold testing was recorded by the patient using a Heft-Parker visual analog scale. Patients' reaction to the cold application was also rated.

RESULTS:

Cold testing at baseline and at 10 minutes resulted in severe pain for both the acetaminophen/hydrocodone and placebo groups. Although pain ratings decreased from 20-60 minutes, the ratings still resulted in moderate pain. Patient reaction to cold testing showed that 56%-62% had a severe reaction. Although the reactions decreased in severity over the 60 minutes, 20%-34% still had severe reactions at 60 minutes. Regarding pain and patients' reactions to cold testing, there were no significant differences between the combination acetaminophen/hydrocodone and placebo groups at any time period.

CONCLUSIONS:

A combination dose of 1000 mg of acetaminophen/10 mg of hydrocodone did not statistically affect cold pulpal testing in patients presenting with symptomatic irreversible pulpitis. Patients experienced moderate to severe pain and reactions to cold testing.

• Authors: Sara Fowler, Spencer Fullmer, Melissa Drum, Al Reader
• Journal: Journal of endodontics (J Endod) Vol. 40 Issue 12 Pg. 1958-60 (Dec 2014) ISSN: 1878-3554 [Electronic] United States
• PMID: 25442725 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Chemical References

• Analgesics, Opioid
• Anti-Inflammatory Agents, Non-Steroidal
• Drug Combinations
• Placebos
• acetaminophen, hydrocodone drug combination
• Acetaminophen
• Hydrocodone

Topics

• Acetaminophen (therapeutic use)
• Adolescent
• Adult
• Aged
• Analgesics, Opioid (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Cold Temperature
• Dental Pulp (drug effects)
• Dental Pulp Test
• Double-Blind Method
• Drug Combinations
• Female
• Humans
• Hydrocodone (therapeutic use)
• Male
• Middle Aged
• Pain Measurement (methods)
• Placebos
• Prospective Studies
• Pulpitis (physiopathology)
• Time Factors
• Toothache (physiopathology)
• Young Adult