Effect of Preoperative Ibuprofen on Pain Perception and Pulse Rate in Paediatric Patients with Deep Caries: A Randomised Controlled Trial

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ABSTRACT

Aim

To evaluate the effect of preoperative ibuprofen on intraoperative pain and stress responses during vital pulp therapy (VPT), a minimally invasive treatment aimed at preserving pulp vitality, in children with reversible pulpitis.

Methods

Forty-four children aged 7–13 years with reversible pulpitis in mandibular first permanent molars were randomly assigned to either the intervention group (10 mg/kg ibuprofen 40 minutes before treatment, n = 22) or the control group (no premedication, n = 22). Pain was assessed intraoperatively using the Visual Analogue Scale (VAS) and pulse rate monitoring. Postoperative VAS scores were recorded on days 1, 3, and 7. Ethical approval was obtained (Approval No: 2024-KAEK-08; 25.12.2024), and the study was registered at ClinicalTrials.gov (NCT07114198).

Results

Intraoperative VAS scores were significantly lower in the ibuprofen group (0.64 ± 1.14) compared with controls (5.05 ± 3.51, p < 0.001). Pulse rate increase during treatment was also significantly reduced in the ibuprofen group (p < 0.001). No significant intergroup differences were observed in postoperative pain at days 1, 3, or 7. A strong correlation was found between intraoperative VAS scores and pulse rate changes (ρ = 0.85, p < 0.001).

Conclusion

Preoperative administration of ibuprofen significantly reduces intraoperative pain and stress responses during VPT in children, improving comfort and cooperation, and may serve as a simple and clinically applicable adjunct in routine paediatric dental practice.

Statistics

Data distribution was evaluated using the Shapiro–Wilk test. Between-group comparisons were performed with independent samples t-test (normally distributed data) and Mann–Whitney U test (non-normally distributed data). Pulse changes within groups were assessed by Wilcoxon signed-rank test. The Kruskal–Wallis test evaluated the effect of treatment modalities on VAS. Spearman’s correlation was used to analyse the relationship between pulse variation and VAS scores. A significance level of p < 0.05 was adopted.

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