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Two study groups were selected, each consisting of 28 patients who exhibited <jats:styled-content style=\"fixed-case\">SIP<\/jats:styled-content> on the first or second mandibular molars. All included patients presented with moderate\u2010to\u2010severe preoperative pain according to the modified Heft\u2010Parker visual analogue scale (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>). Patients were anaesthetized using the <jats:styled-content style=\"fixed-case\">IANB<\/jats:styled-content> technique employing identical cartridges that contained either 1.3 <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> of 2% mepivacaine with epinephrine 1\u00a0:\u00a0100\u00a0000 plus 0.5 <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> of tramadol 50\u00a0mg\u00a0mL<jats:sup>\u22121<\/jats:sup> (experimental group) or 1.8 <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> of 2% mepivacaine with epinephrine 1\u00a0:\u00a0100\u00a0000 (control group). After 15\u00a0min, anaesthesia was evaluated by a progressive four\u2010test examination, that is numbness of the lip, positive or negative cold test, asymptomatic management of dental hard tissues and access to dental pulp. Success of the <jats:styled-content style=\"fixed-case\">IANB<\/jats:styled-content> was defined as the absence of pain during any of these evaluations. The data were analysed with a chi\u2010square, Fisher's or Mann\u2013Whitney <jats:italic>U<\/jats:italic> test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 74 patients were initially assessed, with 56 patients eventually included and 18 excluded. No significant differences in age (<jats:italic>P\u00a0=\u00a0<\/jats:italic>0.384) or gender (<jats:italic>P\u00a0=\u00a0<\/jats:italic>1) were found between the two groups. The success rates of anaesthesia with the <jats:styled-content style=\"fixed-case\">IANB<\/jats:styled-content> for the experimental and control groups were 57.1 and 46.4%, respectively. The success rate of anaesthesia in the experimental group was not significantly different (<jats:italic>P\u00a0\u02c3<\/jats:italic>\u00a00.05) from that of the control group. The duration of the anaesthetic effect was significantly longer for the experimental group (<jats:italic>P\u00a0=\u00a0<\/jats:italic>0.026).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of mepivacaine\u2013tramadol achieved similar success rates for <jats:styled-content style=\"fixed-case\">IANB<\/jats:styled-content> when compared to mepivacaine 2% epinephrine 1\u00a0:\u00a0100\u00a0000. There was no significant difference in the anaesthetic efficacy between the control and experimental solutions, and none of the solutions tested were completely successful.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iej.12463","type":"journal-article","created":{"date-parts":[[2015,5,6]],"date-time":"2015-05-06T06:36:50Z","timestamp":1430894210000},"page":"325-333","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Efficacy of mepivacaine\u2013tramadol combination on the success of inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis: a randomized clinical trial"],"prefix":"10.1111","volume":"49","author":[{"given":"L.","family":"Rodr\u00edguez\u2010Wong","sequence":"first","affiliation":[{"name":"Endodontic Postgraduate Program Faculty of Dentistry San Luis Potosi University San Luis Potos\u00ed 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