Summary
The
objective of this review was to evaluate the efficacy of non-narcotic
analgesics including non-steroidal anti-inflammatory drugs (NSAIDs)
and/or paracetamol in the treatment of post-operative endodontic pain.
Additionally, we aimed to examine the possible association of study
covariates on the pain scores using meta-regression analysis. An
electronic search was performed in 2016. After data extraction and
quality assessment of the included studies (n = 27,
representing 2188 patients), meta-analysis was performed using a
random-effect inverse variance method. Meta-regression analysis was
conducted to examine the associations between effect sizes and
study-level covariates (P < 0·05). The results showed that
administration of non-narcotic analgesic was more effective than placebo
in the management of post-operative pain, resulting in a lower pain
scores with a standardised mean difference of −0·50 (95% CI= −0·70,
−0·30), −0·76 (95%CI= −0·95, −0·56), −1·15 (95% CI= −1·52, −0·78), −0·65
(95% CI= −1·05, −0·26) for immediately after the procedure, 6−, 12− and
24 h post−operative follow-ups (test for statistical heterogeneity: P = 0·000, P = 0·000, P = 0·000 and P = 0·001),
respectively. Our meta-regression analysis provided the evidence for
association between some study covariates with treatment effect, each at
different follow-ups. We concluded that the clinicians can manage
post-operative endodontic pain by administration of NSAIDs and/or
paracetamol. However, analgesic regimens should be considered as
important determinants when prescribing a pharmacological adjuvant.
Comments