The Open Dentistry Journal

ISSN: 1874-2106 ― Volume 14, 2020

Oral Ketorolac with Inferior Alveolar Nerve Block for Irreversible Pulpitis: A Systematic Review and Meta-analysis

Gowri Sivaramakrishnan1, *, Kannan Sridharan2
1 Department of Oral Health, College of Medicine, Nursing and Health Sciences, Fiji National University, Brown Street, Suva, Fiji
2 Department of Pharmacology and Therapeutics, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain



Ketorolac has advantages over other analgesics as a pre-anaesthetic medication. Considering this in mind, the present meta-analysis aims to identify the effect of oral ketorolac premedication on the anaesthetic efficacy of Inferior Alveolar Nerve Block (IANB) in patients with irreversible pulpitis.


Full-texts of eligible studies were obtained from electronic databases. The extracted data was analysed using non-Cochrane mode in RevMan 5.0 software. Relative risk [95% CI] was calculated for the success of IANB.


Four studies were included for the final review. The success rate of IANB on 221 patients with relative risk of 1.87 [1.36, 2.56] was statistically significant favouring ketorolac. The mean difference for VAS in 171 patients was not statistically significant {-13.55 [-33.91, 6.82]}.


Oral ketorolac can be successfully administered as a premedication before conventional inferior alveolar nerve block for endodontic treatment for irreversible pulpitis.

Keywords: Ketorolac, Pre-medication before IANB, Irreversible pulpitis, Pain, Root canal treatment, Endodontics.

Article Information

Identifiers and Pagination:

Year: 2018
Volume: 12
First Page: 340
Last Page: 346
Publisher Id: TODENTJ-12-340
DOI: 10.2174/1874210601812010340

Article History:

Received Date: 28/08/2017
Revision Received Date: 13/04/2018
Acceptance Date: 24/04/2018
Electronic publication date: 30/04/2018
Collection year: 2018

© 2018 Sivaramakrishnan and Sridharan.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Oral Health, College of Medicine, Nursing and Health Sciences, Fiji National University, Brown Street, Suva, Fiji; Tel: +6799090572; E-mail:


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