Related Experiment Video
Updated: Jan 15, 2026

Author Spotlight: Enhancing Dental Pulp Research with Improved Mouse Models
Published on: October 27, 2023
Analgesic Effectiveness of Magnesium Sulfate as an Adjuvant to Local Anesthesia in Symptomatic Irreversible Pulpitis:
Abdulwahab T Alenezi1, Abdalla Alenezi2, Salem Albadi3
1Department of Dentistry, Saad Al-Abdullah Block 2 Polyclinic, Al-Jahra, KWT.
Abstract:
The inferior alveolar nerve block (IANB) is the most commonly used method for inducing pulpal anesthesia in patients with symptomatic irreversible pulpitis (SIP). Magnesium sulfate has been reported to increase the anesthetic effectiveness for endodontic procedures. Whether the adjuvant use of magnesium sulfate with IANB is effective in SIP patients remains uncertain. We performed an electronic search on PubMed, Scopus, Web of Science (WOS), and Cochrane CENTRAL from inception to September 2025 for randomized controlled trials (RCTs) assessing the adjuvant use of magnesium sulfate with IANB and local anesthesia compared to IANB with local anesthesia alone in patients with SIP. The primary outcome of interest was the pain scores following one and two hours post-procedure, while the secondary outcome was the anesthetic success rates. Standardized mean difference (SMD) and risk ratio (RR) with their 95% confidence intervals (CIs) were calculated using a random effects model. All analyses were performed using STATA 19MP. Seven RCTs comprising 398 patients were included in the final analysis. The adjuvant use of magnesium sulfate was associated with significant reductions in post-procedure pain scores at one hour (SMD = -1.97, 95% CI: -3.18 to -0.77, p < 0.001; I2 = 92.98%), without a significant difference at two hours post-procedure (SMD = -0.47, 95% CI: -1 to 0.06, p = 0.08; I2 = 0.00%). In addition, it was associated with higher rates of anesthetic success compared to the control group (RR = 1.61, 95% CI: 1.06 to 2.44, p = 0.02; I2 = 0.00%). The adjuvant use of magnesium sulfate showed a significant reduction in pain scores only at one hour following the procedure, without a significant difference at two hours. Moreover, magnesium sulfate had higher anesthetic success rates compared to the IANB alone. Further long-term RCTs with standardized protocols are recommended to confirm the current findings.
More Related Videos
Related Concept Videos
Local Anesthetics: Adverse Effects
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Analgesia and Pain Management
Local Anesthetics: Differential Sensitivity of Nerve Fibers
Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Local Anesthetics: Clinical Application as Spinal Anesthesia
Local Anesthetics: Chemistry and Structure-Activity Relationship

