Comparative evaluation of anaesthetic efficacy of 0.5 percentage bupivacaine with oral diclofenac potassium vs 0.5 percentage bupivacaine on inferior alveolar nerve block in patients with symptomatic irreversible pulpitis in mandibular first molar A prospective randomized clinical trial

This prospective randomized double blind clinical trial aims to compare the anaesthetic efficacy of 0.5 percent bupivacaine with oral diclofenac potassium versus 0.5 percent bupivacaine alone for inferior alveolar nerve block in patients with symptomatic irreversible pulpitis in mandibular first molars. A total of 60 patients will be randomly allocated into two groups of 30 each. The experimental group will receive a single oral dose of 50 mg diclofenac potassium one hour before administration of inferior alveolar nerve block with 0.5 percent bupivacaine. The control group will receive a placebo tablet one hour before administration of inferior alveolar nerve block with 0.5 percent bupivacaine. Pain scores will be recorded using the Heft Parker Visual Analog Scale at four time points before premedication after local anesthesia during access cavity preparation and during first file placement. Successful anaesthesia is defined as no pain or mild pain on the  VAS scale. Patients aged over 18 years with symptomatic irreversible pulpitis in mandibular first molars who have not taken analgesics within six hours will be included. Patients with allergies to diclofenac or bupivacaine bleeding disorders pregnancy or significant medical conditions will be excluded.